Anesthesia and analgesia
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Anesthesia and analgesia · Jul 2006
The feasibility and complications of the continuous popliteal nerve block: a 1001-case survey.
Perineural catheters are increasingly used worldwide for the treatment of postoperative pain in orthopedics. Long-term complications associated with the placement of a perineural catheter remain largely unstudied. We investigated the efficacy and the acute and late complications associated with the continuous popliteal nerve block. ⋯ These included two cases of inflammation at the puncture site. No infection or neuropathy was observed. The use of continuous popliteal nerve block for ankle or foot surgery is associated with frequent success and few acute and late complications.
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Anesthesia and analgesia · Jul 2006
Dexmedetomidine for pediatric sedation for computed tomography imaging studies.
Dexmedetomidine is a sedative with limited experience in the pediatric population. This is the first study that prospectively evaluates the sedation profile of a dexmedetomidine pilot program for pediatric sedation for radiological imaging studies. In March 2005, our hospital sedation committee approved the replacement of IV pentobarbital with dexmedetomidine as the standard of care for CT imaging. ⋯ No significant changes were observed in respiratory rate or end-tidal CO2. Mean recovery time was 32 +/- 18 minutes. Based on our pilot results, dexmedetomidine may provide a reliable and effective method of providing sedation.
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Anesthesia and analgesia · Jul 2006
Case ReportsShort duration large dose dexmedetomidine in a pediatric patient during procedural sedation.
We describe an infusion of dexmedetomidine at 1.0 microg.kg(-1).min(-1) for 10 min (total dose, 144 microg) sedation in a 3-yr-old child weighing 14 kg. The large dose of dexmedetomidine produced a hemodynamically stable patient who was deeply sedated for approximately 4 h after discontinuing the infusion.
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Anesthesia and analgesia · Jul 2006
The long-term effect of sevoflurane on neuronal cell damage and expression of apoptotic factors after cerebral ischemia and reperfusion in rats.
We investigated the long-term effects of sevoflurane on histopathologic injury and key proteins of apoptosis in a rat hemispheric ischemia/reperfusion model. Sixty-four male Sprague-Dawley rats were randomly assigned to Group 1 (fentanyl and N2O/O2; control) and Group 2 (2.0 vol% sevoflurane and O2/air). Ischemia (45 min) was produced by unilateral common carotid artery occlusion plus hemorrhagic hypotension (mean arterial blood pressure 40 mm Hg). ⋯ Bcl-2 was 100% less in control animals during the first 3 days. Activated caspase-3 was detected in neurons of both groups (0.75%-2.2%). These data support a sustained neuroprotective potency of sevoflurane related to reduced eosinophilic injury after cerebral ischemia/reperfusion.
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Anesthesia and analgesia · Jul 2006
Postoperative nausea and vomiting and pain after transsphenoidal surgery: a review of 877 patients.
Although postoperative nausea and vomiting and pain after supra- and infratentorial craniotomy have been evaluated in multiple studies, there are few data regarding pain or postoperative nausea and vomiting after transsphenoidal procedures. Therefore, we reviewed the perioperative records of 877 patients undergoing transsphenoidal surgery by the same surgeon. The overall incidence of postoperative emesis was 7.5%, significantly less than most studies of neurosurgical patients. ⋯ Interestingly, antiemetic prophylaxis did not decrease the risk of vomiting overall or in any cohort of patients; however, both droperidol and ondansetron decreased the incidence of nausea in the postanesthesia care unit (PACU). Regarding pain and morphine consumption, patients who later developed diabetes insipidus had a significant increase in morphine requirements in the PACU. No other disease state was associated with increased pain or morphine consumption in the PACU.