Anesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
Sciatic nerve block via posterior Labat approach is more efficient than lateral popliteal approach using a double-injection technique: a prospective, randomized comparison.
For peripheral nerve blockade, the double-injection technique proved to be superior to a single injection in previous investigations. The current study was designed to compare onset time and efficacy of two different double-injection approaches for sciatic nerve block with 0.75% ropivacaine. ⋯ A double injection with a relatively low volume of 0.75% ropivacaine generated a higher success rate and a shorter onset time of sensory and motor blockade after the classic Labat approach than after a lateral popliteal approach.
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Randomized Controlled Trial Comparative Study Clinical Trial
Choice of primary anesthetic regimen can influence intensive care unit length of stay after coronary surgery with cardiopulmonary bypass.
Volatile anesthetics protect the myocardium during coronary surgery. This study hypothesized that the use of a volatile agent in the anesthetic regimen would be associated with a shorter intensive care unit (ICU) and hospital length of stay (LOS), compared with a total intravenous anesthetic regimen. ⋯ The use of sevoflurane and desflurane resulted in a shorter ICU and hospital LOS. This seemed to be related to a better preservation of early postoperative myocardial function.
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Comment Letter Randomized Controlled Trial Comparative Study Clinical Trial
Insertion of the nasogastric tube made easy.
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Randomized Controlled Trial Clinical Trial
Preventive analgesia is associated with reduced pain disability 3 weeks but not 6 months after major gynecologic surgery by laparotomy.
Most studies of preemptive or preventive analgesia restrict outcomes to pain and analgesic consumption in the acute postoperative period. The potential longer-term effects on these and other domains of functioning have received little empirical attention. The purpose of this study was to follow up patients who had received general anesthesia plus epidural fentanyl and lidocaine before (group 1) or after (group 2) incision or general anesthesia plus a sham epidural (group 3). ⋯ The short-term beneficial effects of preventive epidural analgesia translated into less pain disability 3 weeks after surgery. Progress in understanding the processes involved in postsurgical recovery and the risk factors for chronic postsurgical pain would be aided by baseline and postsurgical measures of relevant psychological, emotional, and physical variables.
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Randomized Controlled Trial Comparative Study Clinical Trial
Spectral entropy as an electroencephalographic measure of anesthetic drug effect: a comparison with bispectral index and processed midlatency auditory evoked response.
The authors compared the behavior of two calculations of electroencephalographic spectral entropy, state entropy (SE) and response entropy (RE), with the A-Line ARX Index (AAI) and the Bispectral Index (BIS) and as measures of anesthetic drug effect. They compared the measures for baseline variability, burst suppression, and prediction probability. They also developed pharmacodynamic models relating SE, RE, AAI, and BIS to the calculated propofol effect-site concentration (Ceprop). ⋯ Compared with BIS and AAI, both SE and RE seem to be useful electroencephalographic measures of anesthetic drug effect, with low baseline variability and accurate burst suppression prediction. The ability of the measures to predict Ceprop was best for BIS.