Anesthesiology
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Randomized Controlled Trial
Effect of Therapeutic Hypercapnia on Inflammatory Responses to One-lung Ventilation in Lobectomy Patients.
One-lung ventilation (OLV) can result in local and systemic inflammation. This prospective, randomized trial was to evaluate the effect of therapeutic hypercapnia on lung injury after OLV. ⋯ Under intravenous anesthesia, therapeutic hypercapnia inhibits local and systematic inflammation and improves respiratory function after OLV in lobectomy patients without severe complications.
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Randomized Controlled Trial Comparative Study
Intraoperative Methadone for the Prevention of Postoperative Pain: A Randomized, Double-blinded Clinical Trial in Cardiac Surgical Patients.
The intensity of pain after cardiac surgery is often underestimated, and inadequate pain control may be associated with poorer quality of recovery. The aim of this investigation was to examine the effect of intraoperative methadone on postoperative analgesic requirements, pain scores, patient satisfaction, and clinical recovery. ⋯ Intraoperative methadone administration resulted in reduced postoperative morphine requirements, improved pain scores, and enhanced patient-perceived quality of pain management.
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Randomized Controlled Trial
Prediction of Movement to Surgical Stimulation by the Pupillary Dilatation Reflex Amplitude Evoked by a Standardized Noxious Test.
Individual assessment of the amplitude of a physiologic reflex evoked by a standardized noxious test (SNT) before surgical stimulation has been suggested to predict movement upon the forthcoming surgical stimulation. This study aimed to compare the ability of pupillary dilatation reflex amplitude (PDRA) evoked by an SNT and estimated remifentanil effect-site concentration (Ce) to predict movement upon surgical stimulation. ⋯ PDRA evoked by an SNT is as accurate as the estimated remifentanil Ce to predict movement upon cervix dilatation. PDRA could be valuable when estimated opioid Ce is not available or reliable.
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Randomized Controlled Trial
Feasibility of Closed-loop Titration of Propofol and Remifentanil Guided by the Bispectral Monitor in Pediatric and Adolescent Patients: A Prospective Randomized Study.
Closed loop control of propofol/remi TIVA targeting BIS 40-60 is more precise than manual control.
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Randomized Controlled Trial Multicenter Study
Analgesic Effect of Perioperative Escitalopram in High Pain Catastrophizing Patients after Total Knee Arthroplasty: A Randomized, Double-blind, Placebo-controlled Trial.
Sufficient pain treatment remains a challenge after total knee arthroplasty (TKA), especially in high pain catastrophizing patients. Serotonergic signaling may be involved in pain processing, but the effect of selective serotonin reuptake inhibitors on well-defined postoperative pain has not previously been investigated. The authors hypothesized that perioperative escitalopram would reduce pain after TKA in high pain catastrophizing patients. ⋯ Escitalopram did not reduce pain upon ambulation 24 h after TKA in high pain catastrophizing patients. Future studies on optimal timing, dose, and duration of selective serotonin reuptake inhibitor treatment might be warranted.