Anesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
Effect of nicotine replacement therapy on stress and smoking behavior in surgical patients.
Many surgical patients are dependent on nicotine. Smoke-free policies in healthcare facilities mandate abstinence from smoking, which could contribute to psychological stress in the perioperative period. The authors tested the hypothesis that nicotine replacement therapy decreases psychological stress in cigarette smokers scheduled to undergo elective surgery and determined whether nicotine replacement therapy affects postoperative smoking behavior, even when not specifically prescribed to promote abstinence. ⋯ Routine nicotine replacement therapy is not indicated in smokers undergoing surgery for the purposes of managing nicotine withdrawal and stress but can modify some aspects of postoperative smoking behavior.
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Comparative Study
Prolongation of QTc interval after postoperative nausea and vomiting treatment by droperidol or ondansetron.
At dosages above 0.1 mg/kg, droperidol induces a dose-dependent QTc interval prolongation. Although subject to controversy, low-dose droperidol has recently been suspected to induce cardiac arrhythmias. Hence, 5-hydroxytryptamine type 3 antagonists have become the first-line drug for management of postoperative nausea and vomiting. These drugs are also known to prolong the QTc interval at high dosages. This study describes QTc interval changes associated with postoperative nausea and vomiting treatment by droperidol or ondansetron at low doses. ⋯ Droperidol and ondansetron induced similar clinically relevant QTc interval prolongations. When used in treatment of postoperative nausea and vomiting, a situation where prolongation of the QTc interval seems to occur, the safety of 5-hydroxytryptamine type 3 antagonists may not be superior to that of low-dose droperidol.
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Comparative Study
Painful nerve injury decreases resting cytosolic calcium concentrations in sensory neurons of rats.
Neuropathic pain is difficult to treat and poorly understood at the cellular level. Although cytoplasmic calcium ([Ca]c) critically regulates neuronal function, the effects of peripheral nerve injury on resting sensory neuronal [Ca]c are unknown. ⋯ Painful SNL nerve injury depresses resting [Ca]c in sensory neurons. This is most marked in axotomized neurons, especially the large and capsaicin-insensitive neurons presumed to transmit non-nociceptive sensory information.