Anesthesiology
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Left-lateral tilt position is used to reduce assumed aortocaval compression by the pregnant uterus. ⋯ In parturients, the aorta was not compressed, and a 15° left-lateral tilt position did not effectively reduce inferior vena cava compression.
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Preclinical data suggest that oxytocin reduces hypersensitivity by actions in the spinal cord, but whether it produces antinociception to acute stimuli is unclear. In this article, the authors examined the safety of intrathecal oxytocin and screened its effects on acute noxious stimuli. ⋯ This small study supports further investigation on oxytocin for analgesia for hypersensitivity states, with continued systematic surveillance for possible effects on blood pressure, heart rate, and neurologic function.
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Randomized Controlled Trial
Effect of Minocycline on Lumbar Radicular Neuropathic Pain: A Randomized, Placebo-controlled, Double-blind Clinical Trial with Amitriptyline as a Comparator.
Less than 50% of patients experience sufficient pain relief with current drug therapy for neuropathic pain. Minocycline shows promising results in rodent models of neuropathic pain but was not studied in humans with regard to the treatment of neuropathic pain. ⋯ Although both groups differed from placebo, their effect size was small and therefore not likely to be clinically meaningful.
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Meta Analysis
Sodium Bicarbonate and Renal Function after Cardiac Surgery: A Prospectively Planned Individual Patient Meta-analysis.
The effect of urinary alkalinization in cardiac surgery patients at risk of acute kidney injury (AKI) is controversial and trial findings conflicting. Accordingly, the authors performed a prospectively planned individual patient data meta-analysis of the double-blind randomized trials in this field. ⋯ Urinary alkalinization using sodium bicarbonate infusion is not associated with an overall lower incidence of AKI; however, it reduces severe AKI and need for renal replacement therapy in elective coronary artery bypass patients.