Anesthesia and analgesia
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Anesthesia and analgesia · Sep 2007
Randomized Controlled TrialThe effect of neuromuscular block and noxious stimulation on hypnosis monitoring during sevoflurane anesthesia.
There are conflicting results on the influence of neuromuscular block (NMB) on the bispectral index (BIS). We investigated the influence of two degrees of NMB on BIS, Alaris auditory-evoked potential index (AAI), and the electromyogram (EMG) obtained with needle electrodes from the frontal and temporal muscles, immediately adjacent to the BIS-sensor. ⋯ BIS and AAI responses to noxious tetanic electrical stimulation are affected by the degree of NMB during sevoflurane anesthesia whereas NMB does not affect BIS or AAI in the absence of noxious stimulation.
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Anesthesia and analgesia · Sep 2007
Randomized Controlled TrialTransdermal scopolamine for prevention of intrathecal morphine-induced nausea and vomiting after cesarean delivery.
Intrathecal morphine for cesarean delivery provides excellent postoperative analgesia but is associated with significant nausea and vomiting. ⋯ Scopolamine is an effective medication for prophylactic use in parturients receiving intrathecal morphine while undergoing cesarean delivery. Its use, however, was associated with a higher incidence of side effects such as dry mouth and blurry vision.
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Anesthesia and analgesia · Sep 2007
Randomized Controlled TrialObturator versus femoral nerve block for analgesia after total knee arthroplasty.
Both femoral and obturator nerve blocks have been suggested to be useful in relieving pain after total knee arthroplasty (TKA). We sought to compare their efficacy. ⋯ Femoral nerve blocks rarely block the obturator nerve. Single-injection femoral nerve block improved multimodal analgesia after spinal anesthesia for TKA, but this effect did not persist beyond the day of surgery. Obturator nerve block alone was of no benefit.
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Anesthesia and analgesia · Sep 2007
ReviewPathophysiology of peripheral neuropathic pain: immune cells and molecules.
Damage to the peripheral nervous system often leads to chronic neuropathic pain characterized by spontaneous pain and an exaggerated response to painful and/or innocuous stimuli. This pain condition is extremely debilitating and usually difficult to treat. Although inflammatory and neuropathic pain syndromes are often considered distinct entities, emerging evidence belies this strict dichotomy. ⋯ In addition, these cells release numerous compounds that contribute to pain. Recent evidence suggests that immune cells play a role in neuropathic pain in the periphery. In this review we identify the different immune cell types that contribute to neuropathic pain in the periphery and release factors that are crucial in this particular condition.
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Anesthesia and analgesia · Sep 2007
Randomized Controlled Trial Comparative StudyLocal anesthetics and mode of delivery: bupivacaine versus ropivacaine versus levobupivacaine.
The influence of the labor epidural local anesthetic (LA) on mode of delivery has not been adequately studied. In this study, we sought to determine if there is a difference in mode of delivery among parturients who receive epidural bupivacaine, ropivacaine, or levobupivacaine. ⋯ Bupivacaine, ropivacaine, and levobupivacaine all confer adequate labor epidural analgesia, with no significant influence on mode of delivery, duration of labor, or neonatal outcome.