Anesthesia and analgesia
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Anesthesia and analgesia · Mar 2006
Randomized Controlled Trial Comparative StudyThe analgesic effect of nitroglycerin added to lidocaine on intravenous regional anesthesia.
We evaluated the analgesic effect of nitroglycerine (NTG) when added to lidocaine in IV regional anesthesia. Thirty patients undergoing hand surgery were randomly assigned to two groups. The control group (group C, n = 15) received a total dose of 40 mL with 3 mg/kg of lidocaine diluted with saline, and the NTG group (group NTG, n = 15) received an additional 200 mug NTG. ⋯ First analgesic requirement time was longer in group NTG (225 +/- 74 min versus 39 +/- 33 min) than in group C (P < 0.0001). Postoperative analgesic requirements were significantly smaller in group NTG (P < 0.0001) but the side effects were similar in both groups. We conclude that the addition of NTG to lidocaine for IV regional anesthesia improves sensory and motor block, tourniquet pain, and postoperative analgesia without side effects.
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Anesthesia and analgesia · Mar 2006
Randomized Controlled Trial Comparative StudyP6 acupressure does not prevent emesis during spinal anesthesia for cesarean delivery.
Nausea and vomiting are major adverse effects during spinal anesthesia for cesarean delivery. Stimulation of the P6 (Neiguan) acupoint is a traditional Chinese acupuncture technique used for effective antiemetic purposes. In this study, we evaluated the antiemetic effect of P6 acupressure in parturients during spinal anesthesia for cesarean delivery. ⋯ There were no statistically significant differences in maternal characteristics. Incidence rates for intraoperative nausea were 64% (acupressure group) and 71% (control group) (P = 0.416), with an incidence of intraoperative vomiting of 22% (acupressure group) and 27% (control group) (P = 0.506). The results suggest that prophylactic use of acupressure bands bilaterally on the P6 acupoint failed to prevent nausea and vomiting during spinal anesthesia for cesarean delivery.
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Anesthesia and analgesia · Mar 2006
Meta AnalysisAvoiding transfusions in children undergoing cardiac surgery: a meta-analysis of randomized trials of aprotinin.
Aprotinin, a potent antifibrinolytic drug, reduces the proportion of adults who receive blood transfusions during cardiac surgery, although the effect in children remains unclear. We performed a systematic review of the literature to identify all English language, randomized controlled trials of aprotinin involving children undergoing corrective or palliative cardiac surgery with cardiopulmonary bypass. All studies were assessed for methodological quality, and sources of heterogeneity were examined. ⋯ Most of the studies were of poor methodological quality and predefined transfusion triggers were infrequently used. Overall, aprotinin reduced the proportion of children who received blood transfusion during cardiac surgery with cardiopulmonary bypass. Further high-quality trials with clinically important outcomes may be warranted before aprotinin can be routinely recommended in this population.
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Anesthesia and analgesia · Mar 2006
Comparative StudyVasotrac arterial blood pressure and direct arterial blood pressure monitoring during liver transplantation.
During liver transplantation two arterial catheters are often placed. The Vasotrac is a noninvasive monitor that provides radial arterial blood pressures by a tonometric method. We investigated whether the Vasotrac would be an accurate substitute for an arterial catheter by comparing Vasotrac blood pressures with simultaneous direct radial blood pressures recorded from the contralateral arm in 14 patients undergoing liver transplantation. ⋯ Correlation was 0.82. Vasotrac bias was +3.3 mm Hg and limits of agreement +/-15 mm Hg. We conclude that the Vasotrac is not adequately accurate to substitute for direct arterial blood pressure monitoring in liver transplantation.
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Anesthesia and analgesia · Mar 2006
Randomized Controlled Trial Comparative StudyInfraclavicular brachial plexus block versus humeral block in trauma patients: a comparison of patient comfort.
In this prospective randomized study, we compared humeral block (HB) and infraclavicular brachial plexus block (ICB) with pain caused by the block as a primary outcome, assuming that ICB would cause less pain than HB. Patients undergoing emergency upper limb surgery were included in this study and received either ICB (group I, n = 52 patients) or HB (group H, n = 52 patients). Patients were asked to quantify the severity of the pain during the procedure using a visual analog scale from 0 to 100 mm and to identify which of the 4 components of the procedure was most unpleasant (skin transfixion, needle redirection in search of the nerves, local anesthetic injections, or electrical stimulation). ⋯ The onset time was 13 +/- 7 min for ICB and 9 +/- 3 min for HB (P < 0.05). No serious complications were observed. In summary, ICB is less painful, compared with HB, with a similar success rate.