Anesthesiology
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Randomized Controlled Trial Comparative Study
Bilateral Suprazygomatic Maxillary Nerve Block for Cleft Palate Repair in Children: A Prospective, Randomized, Double-blind Study versus Placebo.
Bilateral suprazygomatic maxillary nerve block significantly reduces 48 hour morphine requirements in children having cleft palate repair.
pearl -
Randomized Controlled Trial
A Response Surface Model Approach for Continuous Measures of Hypnotic and Analgesic Effect during Sevoflurane-Remifentanil Interaction: Quantifying the Pharmacodynamic Shift Evoked by Stimulation.
The authors studied the interaction between sevoflurane and remifentanil on bispectral index (BIS), state entropy (SE), response entropy (RE), Composite Variability Index, and Surgical Pleth Index, by using a response surface methodology. The authors also studied the influence of stimulation on this interaction. ⋯ By combining pre- and poststimulation data, interaction models for BIS, SE, and RE demonstrate a consistent influence of "stimulation" on the pharmacodynamic relationship between sevoflurane and remifentanil. Significant population variability exists for Composite Variability Index and Surgical Pleth Index.
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Randomized Controlled Trial
Synergistic Interaction between Fentanyl and Bupivacaine Given Intrathecally for Labor Analgesia.
Intrathecal fentanyl synergistically improves labour analgesia when given in combination with bupivacaine.
pearl -
Randomized Controlled Trial
Pulmonary Function after Emergence on 100% Oxygen in Patients with Chronic Obstructive Pulmonary Disease: A Randomized, Controlled Trial.
During emergence from anesthesia, breathing 100% oxygen is frequently used to provide a safety margin toward hypoxemia in case an airway problem occurs. Oxygen breathing has been shown to cause pulmonary gas exchange disorders in healthy individuals. This study investigates how oxygen breathing during emergence affects lung function specifically whether oxygen breathing causes added hypoxemia in patients with chronic obstructive pulmonary disease. ⋯ In this experiment, the authors examined oxygen breathing during emergence-a widely practiced maneuver known to generate pulmonary blood flow heterogeneity. In the observed cohort of patients already presenting with pulmonary blood flow disturbances, emergence on oxygen resulted in deterioration of oxygen-related blood gas parameters. In the perioperative care of patients with chronic obstructive pulmonary disease, oxygen breathing during emergence from anesthesia may need reconsideration.
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Randomized Controlled Trial
Bilateral Hypersensitivity to Capsaicin, Thermal, and Mechanical Stimuli in Unilateral Complex Regional Pain Syndrome.
Complex regional pain syndrome is multifactorial. Exaggerated inflammatory responses to limb injury may be involved. The authors hypothesized that capsaicin-induced pain and neurogenic inflammation (skin perfusion and flare area) are increased in patients with complex regional pain syndrome compared with that in controls. ⋯ The main finding is bilaterally increased capsaicin-induced pain in patients compared with controls. The flare response to capsaicin was normal, suggesting that the increased pain response was not due to increased neurogenic inflammation. The bilateral hypersensitivity to painful chemical, thermal, and mechanical stimuli not confined to the innervation area of a peripheral nerve or root cannot be explained by a regional change and may partly be due to central sensitization.