Anesthesia and analgesia
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Anesthesia and analgesia · Jan 2008
Randomized Controlled TrialPremedication with mirtazapine reduces preoperative anxiety and postoperative nausea and vomiting.
Mirtazapine is a new antidepressant that blocks 5-HT2 and 5-HT3 receptors. With this receptor profile, it is possible that mirtazapine could provide both anxiolysis and efficacy for postoperative nausea and vomiting (PONV). We therefore tested the hypothesis that premedication with mirtazapine can reduce preoperative anxiety and PONV. ⋯ Premedication with mirtazapine 30 mg reduces the level of preoperative anxiety and the risk of PONV in moderate and high-risk female patients.
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Anesthesia and analgesia · Jan 2008
Randomized Controlled Trial Comparative StudyCan remifentanil replace nitrous oxide during anesthesia for ambulatory orthopedic surgery with desflurane and fentanyl?
The administration of nitrous oxide (N2O) may be associated with side effects and toxicities. Remifentanil shares characteristics with N2O, including MAC-reducing and antinociceptive effects and a rapid decrease in clinical effect when discontinued. We compared the outcome after ambulatory orthopedic surgery with desflurane and fentanyl supplemented with clinically equivalent doses of either N2O or remifentanil. ⋯ This study demonstrates that a remifentanil infusion of 0.085 microg x kg(-1) x min(-1) may be substituted for 66% N2O during desflurane/fentanyl anesthesia without any clinically significant change in outcome.
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Anesthesia and analgesia · Jan 2008
Randomized Controlled TrialPreoperative gabapentin: the effect on ropivacaine subarachnoid block and hemodynamics.
Gabapentin is an adjuvant analgesic and may enhance the spread of subarachnoid block. We investigated the effects of pretreatment with gabapentin on subarachnoid block characteristics and hemodynamics. ⋯ Pretreatment with gabapentin had no effect on the spread of sensory block or the regression of motor block but was associated with lower systolic arterial blood pressure values in patients undergoing subarachnoid anesthesia with ropivacaine.
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Anesthesia and analgesia · Jan 2008
The impact of intraoperative transfusion of platelets and red blood cells on survival after liver transplantation.
Intraoperative transfusion of red blood cells (RBC) is associated with adverse outcome after orthotopic liver transplantation (OLT). Although experimental studies have shown that platelets contribute to reperfusion injury of the liver, the influence of allogeneic platelet transfusion on outcome has not been studied in detail. In this study, we evaluate the impact of various blood products on outcome after OLT. ⋯ This retrospective study indicates that, in addition to RBC, platelet transfusions are an independent risk factor for survival after OLT. These findings have important implications for transfusion practice in liver transplant recipients.
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Anesthesia and analgesia · Jan 2008
Real-time checking of electronic anesthesia records for documentation errors and automatically text messaging clinicians improves quality of documentation.
The quality of electronic anesthesia documentation is important for downstream communication and to demonstrate appropriate diligence to care. Documentation quality will also impact the success of reimbursement contracts that require timely and complete documentation of specific interventions. We implemented a system to improve completeness of clinical documentation and evaluated the results over time. ⋯ Electronic anesthesia documentation performance can be rapidly managed and improved by using an automatic process monitoring and alerting system.