Anesthesiology
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Randomized Controlled Trial Comparative Study
Randomized Double-blinded Comparison of Norepinephrine and Phenylephrine for Maintenance of Blood Pressure during Spinal Anesthesia for Cesarean Delivery.
During spinal anesthesia for cesarean delivery, phenylephrine can cause reflexive decreases in maternal heart rate and cardiac output. Norepinephrine has weak β-adrenergic receptor agonist activity in addition to potent α-adrenergic receptor activity and therefore may be suitable for maintaining blood pressure with less negative effects on heart rate and cardiac output compared with phenylephrine. ⋯ When given by computer-controlled infusion during spinal anesthesia for cesarean delivery, norepinephrine was effective for maintaining blood pressure and was associated with greater heart rate and cardiac output compared with phenylephrine. Further work would be of interest to confirm the safety and efficacy of norepinephrine as a vasopressor in obstetric patients.
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Randomized Controlled Trial
A Randomized Controlled Trial of Adaptive Support Ventilation Mode to Wean Patients after Fast-track Cardiac Valvular Surgery.
Adaptive support ventilation can speed weaning after coronary artery surgery compared with protocolized weaning using other modes. There are no data to support this mode of weaning after cardiac valvular surgery. Furthermore, control group weaning times have been long, suggesting that the results may reflect control group protocols that delay weaning rather than a real advantage of adaptive support ventilation. ⋯ Adaptive support ventilation reduces ventilation time by more than 2 h in patients who have undergone fast-track cardiac valvular surgery while reducing the number of manual ventilator changes and alarms.
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Randomized Controlled Trial
Up-regulation of Programmed Cell Death 1 Ligand 1 on Neutrophils May Be Involved in Sepsis-induced Immunosuppression: An Animal Study and a Prospective Case-control Study.
Recent studies have shown that neutrophils may display an antigen-presenting function and inhibit lymphocyte proliferation by expressing programmed cell death 1 ligand 1 (PD-L1). The current study was performed to investigate the effect of neutrophils and their pathophysiological significance during sepsis. ⋯ PD-L1 is up-regulated on neutrophils during sepsis, which may be related to sepsis-induced immunosuppression.
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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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Randomized Controlled Trial Comparative Study
A Randomized Control Trial of Bupivacaine and Fentanyl versus Fentanyl-only for Epidural Analgesia during the Second Stage of Labor.
Fentanyl-only epidural infusion shows no benefit over fentanyl/bupiv in respect to duration of labor, motor block, delivery, analgesia, or outcomes.
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