Anesthesia and analgesia
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Anesthesia and analgesia · Oct 2008
ReviewP6 stimulation for the prevention of nausea and vomiting associated with cesarean delivery under neuraxial anesthesia: a systematic review of randomized controlled trials.
A number of studies investigated the use of P6 stimulation for the prevention of intraoperative and postoperative nausea and vomiting (IONV and PONV) in women having cesarean delivery under neuraxial anesthesia. We performed a systematic review to determine the overall efficacy of these techniques in preventing IONV and PONV in this patient population. ⋯ While some studies showed a benefit of P6 stimulation, this finding was not consistent. The presence of heterogeneity and inconsistent results among the included trials prevents any definitive conclusions on the efficacy of P6 stimulation in reducing IONV and PONV associated with cesarean delivery performed under neuraxial anesthesia.
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Anesthesia and analgesia · Oct 2008
Randomized Controlled Trial Comparative StudyA "new" automated bolus technique for continuous popliteal block: a prospective, randomized comparison with a continuous infusion technique.
We designed the present, prospective, randomized, double-blind study to compare the administration of an automated intermittent bolus dose with a conventional technique of continuous infusion of local anesthetic for postoperative analgesia in continuous popliteal sciatic nerve blockade. ⋯ The present investigation demonstrated that local anesthetic administered by an automated bolus technique provided better postoperative pain relief than a continuous infusion technique for continuous popliteal nerve block after foot surgery.
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Anesthesia and analgesia · Oct 2008
Randomized Controlled TrialIntraoperative low-dose ketamine does not prevent a remifentanil-induced increase in morphine requirement after pediatric scoliosis surgery.
Remifentanil-based anesthesia is commonly used to facilitate neurophysiologic monitoring during pediatric scoliosis surgery. Acute opioid tolerance and/or hyperalgesia resulting from remifentanil-based anesthesia may involve activation of N-methyl-D-aspartate systems. We hypothesized that low-dose intraoperative infusion of the N-methyl-d-aspartate antagonist ketamine would suppress the development of tolerance and thereby decrease postoperative morphine consumption in children receiving remifentanil-based anesthesia for scoliosis surgery. ⋯ These data do not support the use of intraoperative low-dose ketamine to prevent the development of remifentanil-induced acute opioid tolerance and/or hyperalgesia during pediatric scoliosis surgery.
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Anesthesia and analgesia · Oct 2008
Randomized Controlled Trial Comparative StudyGum elastic bougie-guided insertion of the ProSeal laryngeal mask airway is superior to the digital and introducer tool techniques in patients with simulated difficult laryngoscopy using a rigid neck collar.
We compared three techniques for insertion of the laryngeal mask airway ProSeal (PLMA) in patients with simulated difficult laryngoscopy using a rigid neck collar. ⋯ The guided insertion technique is more frequently successful than the digital or IT techniques in patients with simulated difficult laryngoscopy using a rigid neck collar.
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Anesthesia and analgesia · Oct 2008
Multicenter StudyPulse pressure and risk of adverse outcome in coronary bypass surgery.
Among ambulatory patients, an increase in pulse pressure (PP) is a well-established determinant of vascular risk. The relationship of PP and acute perioperative vascular outcome among patients having coronary artery bypass graft (CABG) surgery is less well known. ⋯ An increase in PP was independently and significantly associated with greater fatal and nonfatal adverse cerebral and cardiac outcomes in patients having CABG surgery. These findings highlight the associated risks of preoperative PP on acute postoperative vascular outcomes.