Anesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
Continuous infusion of ropivacaine for pain relief after iliac crest bone grafting for shoulder surgery.
The aim of the study was to compare the efficacy of either ropivacaine or placebo through an iliac crest (IC) catheter after Bankart repair with IC bone grafting. ⋯ Continuous application of 0.2% ropivacaine through an IC catheter after Bankart repair with IC bone grafting is an effective method for pain relief for the first 48 h, with few adverse effects and high patient satisfaction. The benefit of this technique is still present after 3 months.
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Randomized Controlled Trial Comparative Study Clinical Trial
Intraoperative remifentanil infusion does not increase postoperative opioid consumption compared with 70% nitrous oxide.
Remifentanil is commonly used to replace nitrous oxide in general anesthesia to avoid the side effects of the latter. However, there are reports that intraoperative remifentanil infusion can lead to acute opioid tolerance. In this study, the authors tried to determine the dose of remifentanil comparable in efficacy to 70% nitrous oxide and to evaluate its effect on postoperative pain and morphine consumption after colorectal surgery using isoflurane anesthesia. ⋯ The substitution of 70% nitrous oxide with remifentanil at a mean infusion rate of 0.17 mug . kg . minute for colorectal surgery did not affect postoperative opioid consumption.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Recombinant coagulation factor VIIa in major liver resection: a randomized, placebo-controlled, double-blind clinical trial.
Prevention of bleeding episodes in noncirrhotic patients undergoing partial hepatectomy remains unsatisfactory in spite of improved surgical techniques. The authors conducted a randomized, placebo-controlled, double-blind trial to evaluate the hemostatic effect and safety of recombinant factor VIIa (rFVIIa) in major partial hepatectomy. ⋯ Recombinant factor VIIa dosing did not result in a statistically significant reduction in either the number of patients transfused or the volume of blood products administered. No safety issues were identified.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects of epidural saline injection on cerebrospinal fluid volume and velocity waveform: a magnetic resonance imaging study.
The phenomenon of epidural "top-up" (increased spread of local anesthetic due to epidural fluid injection) is explained partly by an epidural volume effect. This study was designed to investigate the change in cerebrospinal fluid (CSF) volume and velocity waveform induced by epidural saline injection. ⋯ These findings indicate that the reduction in CSF volume was injection-volume dependent, dural compression lasted at least 30 min after saline injection, and the changes of the CSF flow dynamics did not correlate with the degree of dural sac compression.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
A phase III, double-blind, placebo-controlled, multicenter study on the efficacy of recombinant human antithrombin in heparin-resistant patients scheduled to undergo cardiac surgery necessitating cardiopulmonary bypass.
The study evaluated the efficacy of recombinant human antithrombin (rhAT) for restoring heparin responsiveness in heparin resistant patients undergoing cardiac surgery. ⋯ Treatment with 75 U/kg rhAT is effective in restoring heparin responsiveness and promoting therapeutic anticoagulation in the majority of heparin-resistant patients. Treating heparin-resistant patients with rhAT may decrease the requirement for heparin and fresh frozen plasma.