Anesthesiology
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Randomized Controlled Trial Clinical Trial
Motor and somatosensory evoked potentials are well maintained in patients given dexmedetomidine during spine surgery.
Many commonly used anesthetic agents produce a dose-dependent amplitude reduction and latency prolongation of evoked responses, which may impair diagnosis of intraoperative spinal cord injury. Dexmedetomidine is increasingly used as an adjunct for general anesthesia. Therefore, the authors tested the hypothesis that dexmedetomidine does not have a clinically important effect on somatosensory and transcranial motor evoked responses. ⋯ Use of dexmedetomidine as an anesthetic adjunct at target plasma concentrations up to 0.6 ng/ml does not change somatosensory or motor evoked potential responses during complex spine surgery by any clinically significant amount.
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Randomized Controlled Trial
Antiinflammatory effect of peripheral nerve blocks after knee surgery: clinical and biologic evaluation.
Nerve blocks provide analgesia after surgery. The authors tested whether nerve blocks have antiinflammatory effects. ⋯ Nerve blocks inhibited clinical inflammation after total knee arthroplasty, with no change in tissue and plasma cytokine concentrations.
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Intraneural injection during peripheral nerve blockade can cause neurologic injury. Current approaches to prevent or detect intraneural injection lack reliability and consistency, or only signal intraneural injection upon the event. A change in electrical impedance (EI) could be indicative of intraneural needle placement before injection. ⋯ With further study, EI could prove to be a quantifiable warning signal to alert clinicians to intraneural needle placement, preventing local anesthetic injection and subsequent nerve injury.