Anesthesia and analgesia
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Anesthesia and analgesia · Apr 2007
ReviewNeurological complications after regional anesthesia: contemporary estimates of risk.
Regional anesthesia (RA) provides excellent anesthesia and analgesia for many surgical procedures. Anesthesiologists and patients must understand the risks in addition to the benefits of RA to make an informed choice of anesthetic technique. Many studies that have investigated neurological complications after RA are dated, and do not reflect the increasing indications and applications of RA nor the advances in training and techniques. In this brief narrative review we collate the contemporary investigations of neurological complications after the most common RA techniques. ⋯ Our review suggests that the rate of neurological complications after central nerve blockade is <4:10,000, or 0.04%. The rate of neuropathy after PNB is <3:100, or 3%. However, permanent neurological injury after RA is rare in contemporary anesthetic practice.
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Anesthesia and analgesia · Apr 2007
Comparative StudyThe effect of albumin concentration on plasma sodium and chloride measurements in critically ill patients.
We tested the hypothesis that the difference between indirect and direct sodium assays would be related to the plasma albumin concentration. Further, we proposed that differences between indirect and direct chloride assays might be explained by interference from other plasma constituents, particularly bicarbonate, and possibly albumin. ⋯ The central laboratory and ICUs assays are analytically, statistically, and clinically different for both sodium and chloride. Unless taken into account, the differences could be large enough in hypoalbuminemic populations (such as critically ill patients) to affect clinical diagnosis and decision making.
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Anesthesia and analgesia · Apr 2007
Exploring sociodemographic and personality characteristic predictors of parental pain perceptions.
We studied the relationship between children's and parents' sociodemographic and personality characteristics and parents' perceptions of their children's pain. ⋯ We conclude that many parents have misconceptions of pain and analgesics, and that child and parent personality characteristics can be used to identify parents at risk of these misconceptions.
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Anesthesia and analgesia · Apr 2007
Randomized Controlled TrialSpinal anesthesia with lidocaine or preservative-free 2-chlorprocaine for outpatient knee arthroscopy: a prospective, randomized, double-blind comparison.
In this prospective, randomized, double-blind study we tested the hypothesis that 50 mg of 1% preservative-free 2-chloroprocaine would provide a faster resolution of spinal block than the same dose of 1% plain lidocaine. ⋯ Intrathecal injection of 50 mg of preservative-free 2-chloroprocaine 1% resulted in quicker recovery of sensory/motor function, and unassisted ambulation, and fewer incidences of transient neurologic symptoms than the same dose of 1% lidocaine.
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Anesthesia and analgesia · Apr 2007
Randomized Controlled TrialThe addition of a small-dose ketamine infusion to tramadol for postoperative analgesia: a double-blinded, placebo-controlled, randomized trial after abdominal surgery.
There are few data on combining ketamine with tramadol for postoperative analgesia in humans. We tested the hypothesis that adding ketamine to tramadol would improve analgesia after major abdominal surgery. ⋯ Small-dose ketamine was a useful addition to tramadol and morphine after major abdominal surgery.