Anesthesia and analgesia
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Anesthesia and analgesia · Jan 2007
Controlled Clinical TrialIntravenous lidocaine after tracheal intubation mitigates bronchoconstriction in patients with asthma.
Although prophylactic IV administration of lidocaine attenuates the response to a variety of inhalation challenges, its effect on airway resistance after endotracheal intubation in patients with asthma is unclear. We tested the hypothesis that IV lidocaine attenuates intubation-evoked bronchoconstriction in patients with asthma. ⋯ IV lidocaine given after endotracheal intubation mitigates bronchoconstriction in patients with asthma.
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Anesthesia and analgesia · Jan 2007
Randomized Controlled TrialMonitoring brain oxygen saturation during coronary bypass surgery: a randomized, prospective study.
Cerebral deoxygenation is associated with various adverse systemic outcomes. We hypothesized, by using the brain as an index organ, that interventions to improve cerebral oxygenation would have systemic benefits in cardiac surgical patients. ⋯ Monitoring cerebral rSO2 in coronary artery bypass patients avoids profound cerebral desaturation and is associated with significantly fewer incidences of major organ dysfunction.
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Anesthesia and analgesia · Jan 2007
Randomized Controlled TrialTransdermal scopolamine: an alternative to ondansetron and droperidol for the prevention of postoperative and postdischarge emetic symptoms.
Given the controversy regarding the use of droperidol and the high cost of the 5-HT3 antagonists, a cost-effective alternative for routine use as a prophylactic antiemetic would be desirable. We designed two parallel, randomized, double-blind sham and placebo-controlled studies to compare the early and late antiemetic efficacy and adverse event profile of transdermal scopolamine (TDS) 1.5 mg, to ondansetron 4 mg IV, and droperidol 1.25 mg IV for antiemetic prophylaxis as part of a multimodal regimen in "at risk" surgical populations. ⋯ Premedication with TDS was as effective as droperidol (1.25 mg) or ondansetron (4 mg) in preventing nausea and vomiting in the early and late postoperative periods. However, the use of a TDS patch is more likely to produce a dry mouth.
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Anesthesia and analgesia · Jan 2007
Randomized Controlled TrialThe analgesic efficacy of transversus abdominis plane block after abdominal surgery: a prospective randomized controlled trial.
The transversus abdominis plane (TAP) block is a novel approach for blocking the abdominal wall neural afferents via the bilateral lumbar triangles of Petit. We evaluated its analgesic efficacy in patients during the first 24 postoperative hours after abdominal surgery, in a randomized, controlled, double-blind clinical trial. ⋯ The TAP block provided highly effective postoperative analgesia in the first 24 postoperative hours after major abdominal surgery.
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Anesthesia and analgesia · Jan 2007
Meta AnalysisPerioperative beta-blockers for preventing surgery-related mortality and morbidity: a systematic review and meta-analysis.
Perioperative beta-blockers are suggested to reduce cardiovascular mortality, myocardial-ischemia/infarction, and supraventricular arrhythmias after surgery. We reviewed the evidence regarding the effectiveness of perioperative beta-blockers for improving patient outcomes after cardiac and noncardiac surgery. ⋯ Beta-blockers reduced perioperative arrhythmias and myocardial ischemia, but they had no effect on myocardial infarction, mortality, or length of hospitalization.