Anesthesia and analgesia
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Anesthesia and analgesia · Nov 2006
Randomized Controlled Trial Comparative StudyThe additive interactions between ondansetron and droperidol for preventing postoperative nausea and vomiting.
Prophylactic ondansetron or droperidol reduces the incidence of postoperative nausea and vomiting (PONV). Previous studies showed that the combination of these two drugs produced better antiemetic effect than either drug alone. We present a nonparametric method to determine the pharmacologic interaction between ondansetron and droperidol and compared the observed response of the drug combination with that predicted from additivity. ⋯ We conclude that the interaction between ondansetron and droperiodol was additive. Both drugs acted independently of each other through their specific mechanisms of action. The incidence of QTc prolongation did not increase with the drug combination.
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Anesthesia and analgesia · Nov 2006
Randomized Controlled Trial Comparative StudyThe twenty-degree reverse-Trendelenburg position decreases the incidence and severity of postoperative nausea and vomiting after thyroid surgery.
In this randomized, single-blind, controlled study, we evaluated whether the 20 degrees reverse-Trendelenburg position had an effect on postoperative nausea and vomiting in patients undergoing thyroid surgery. ⋯ The 20 degrees reverse-Trendelenburg position effectively ameliorates postoperative nausea and/or vomiting.
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Anesthesia and analgesia · Nov 2006
Comparative StudyExperimental heat pain for detecting pregnancy-induced analgesia in humans.
Animal studies suggest that increased circulating estrogen and progesterone, and activation of the endorphin system cause prenancy-induced antinociceptive effects. Human studies have provided inconsistent results and have often lacked a nonpregnant control group. In this study, we compared sensitivity to experimental heat and cold pain in pregnant and nonpregnant women. ⋯ Pregnancy-induced analgesic effects at term can be detected in a model of experimental heat pain. These effects persist during the first 24-48 h after delivery. Experimental heat pain is a suitable modality for further characterizing the phenomenon of pregnancy-induced analgesia in humans.
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Anesthesia and analgesia · Nov 2006
Comparative StudyNeurologic complications after neuraxial anesthesia or analgesia in patients with preexisting peripheral sensorimotor neuropathy or diabetic polyneuropathy.
The risk of severe neurologic injury after neuraxial blockade is extremely rare among the general population. However, patients with preexisting neural compromise may be at increased risk of further neurologic sequelae after neuraxial anesthesia or analgesia. ⋯ The risk of severe postoperative neurologic dysfunction in patients with peripheral sensorimotor neuropathy or diabetic polyneuropathy undergoing neuraxial anesthesia or analgesia was found to be 0.4% (95% CI 0.1%-1.3%). Clinicians should be aware of this potentially high-risk subgroup of patients when developing and implementing a regional anesthetic care plan.
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Anesthesia and analgesia · Nov 2006
Comparative StudyEducating anesthesiology residents to perform percutaneous cricothyrotomy, retrograde intubation, and fiberoptic bronchoscopy using preserved cadavers.
Experience with invasive airway procedures may be difficult to obtain during residency training, and anesthesiologists may therefore be hesitant to use these life-saving techniques. We designed a prospective study to determine whether using embalmed cadavers to teach percutaneous cricothyrotomy (PC), retrograde intubation (RI), and fiberoptic intubation to anesthesiology residents would improve their perceived procedural confidence and ability. After demonstration of these techniques by experienced attending physicians, residents were allowed to practice, with instructor guidance, on the cadavers. ⋯ Likewise, the number of residents who reported they would use RI increased from 6% to 67% (P