Anesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of median effective doses of intrathecal levobupivacaine and ropivacaine for labor analgesia.
The study was designed to determine and compare the median effective doses (MEDs) of intrathecal ropivacaine with levobupivacaine for labor analgesia. ⋯ The MED of intrathecal ropivacaine for labor analgesia was significantly greater than levobupivacaine experimentally, but this significance was reduced when the comparison was based on molar potency. There was no difference in the duration of analgesia or adverse effects between the two drugs at higher doses (2.5 mg or greater).
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Randomized Controlled Trial Clinical Trial
Effects of bispectral index monitoring on recovery from surgical anesthesia in 1,580 inpatients from an academic medical center.
The purpose of this study was to determine whether monitoring Bispectral Index (BIS) would affect recovery parameters in patients undergoing inpatient surgery. ⋯ The use of BIS monitoring for inpatients undergoing a wide variety of surgical procedures in an academic medical center had some minor effects on intraoperative anesthetic use but had no impact on recovery parameters.
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Predicting a patient's response to a particular drug has long been a goal of clinicians. Rapid advances in molecular biology have enabled researchers to identify associations between an individual's genetic profile and drug response. Pharmacogenetics is the study of the molecular mechanisms that underlie individual differences in drug metabolism, efficacy, and side effects. The pharmacogenetics of commonly used anesthetic and analgesic agents are reviewed.
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Randomized Controlled Trial Clinical Trial
Minimum local analgesic doses of ropivacaine, levobupivacaine, and bupivacaine for intrathecal labor analgesia.
Doses for intrathecal opioid-local anesthetic mixtures have been arbitrarily chosen. The aim of this study was to compare the analgesic efficacies of intrathecal ropivacaine, levobupivacaine, and bupivacaine for labor analgesia and to determine the analgesic potency ratios for these three drugs. For this purpose, the authors used the up-down sequential allocation model, which estimates the minimum local analgesic dose for intrathecal local anesthetic. ⋯ This study suggests a potency hierarchy of spinal bupivacaine > levobupivacaine > ropivacaine.
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Anesthetic requirement in redheads is exaggerated, suggesting that redheads may be especially sensitive to pain. Therefore, the authors tested the hypotheses that women with natural red hair are more sensitive to pain and that redheads are resistant to topical and subcutaneous lidocaine. ⋯ Red hair is the phenotype for mutations of the melanocortin-1 receptor. Results indicate that redheads are more sensitive to thermal pain and are resistant to the analgesic effects of subcutaneous lidocaine. Mutations of the melanocortin-1 receptor, or a consequence thereof, thus modulate pain sensitivity.