Anesthesia and analgesia
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Anesthesia and analgesia · Jan 2008
Randomized Controlled TrialThe efficacy of ketamine for the treatment of postoperative shivering.
There are few reports on the utility of ketamine for the prevention of postoperative shivering. We thus established the efficacy of two doses of ketamine compared with meperidine for the treatment of postoperative shivering. ⋯ Ketamine 0.5-0.75 mg/kg is more rapid than meperidine (25 mg) for the reduction of postoperative shivering, but the side effect profile may limit its usefulness.
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Anesthesia and analgesia · Jan 2008
Randomized Controlled TrialEpinephrine 4 microg/mL added to a low-dose mixture of ropivacaine and fentanyl for lumbar epidural analgesia after total knee arthroplasty.
Epinephrine 2 microg/mL added to a local anesthetic-opioid mixture has been found to improve postoperative continuous epidural analgesia at the thoracic (TEA) but not at lumbar (LEA) level. Therefore, we studied whether a higher dose of epinephrine could improve LEA. ⋯ As part of the multimodal pain treatment used, the epidural adjuvant epinephrine 4 microg/mL (12-32 microg/h) did not improve LEA after total knee arthroplasty.
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Anesthesia and analgesia · Jan 2008
Randomized Controlled TrialThe analgesic efficacy of transversus abdominis plane block after cesarean delivery: a randomized controlled trial.
The transversus abdominis plane (TAP) block is an effective method of providing postoperative analgesia in patients undergoing midline abdominal wall incisions. We evaluated its analgesic efficacy over the first 48 postoperative hours after cesarean delivery performed through a Pfannensteil incision, in a randomized controlled, double-blind, clinical trial. ⋯ The TAP block, as a component of a multimodal analgesic regimen, provided superior analgesia when compared with placebo block up to 48 postoperative hours after elective cesarean delivery.
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Anesthesia and analgesia · Jan 2008
Clinical TrialThe median effective dose of preemptive gabapentin on postoperative morphine consumption after posterior lumbar spinal fusion.
A single dose of preemptive gabapentin reduces postoperative pain and postoperative analgesic consumption. However, the optimal dose of preemptive gabapentin remains to be evaluated. ⋯ Given the large dose of gabapentin needed, further powered studies are warranted to assess side effects.
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Anesthesia and analgesia · Jan 2008
Clinical TrialCompliance and dead space fraction indicate an optimal level of positive end-expiratory pressure after recruitment in anesthetized patients.
"Optimal" positive end-expiratory pressure (PEEP) can be defined as the PEEP that prevents recollapse after a recruitment maneuver, avoids over-distension, and, consequently, leads to optimal lung mechanics at minimal dead space ventilation. In this study, we analyzed the effects of PEEP and recruitment on functional residual capacity (FRC), compliance, arterial oxygen partial pressure (Pao2) and dead space fraction, and we determined the most suitable variables indicating optimal PEEP. ⋯ All variables showed the positive effects of PEEP in conjunction with a recruitment maneuver. Optimal PEEP was 10 cm H2O because at this pressure level the highest compliance value in conjunction with the lowest dead space fraction indicated a maximum amount of effectively expanded alveoli. FRC and Pao2 were insensitive to alveolar over-distension.