Anesthesia and analgesia
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Anesthesia and analgesia · Mar 2008
The effect of limited rewarming and postoperative hypothermia on cognitive function in a rat cardiopulmonary bypass model.
Clinical studies have failed to demonstrate significant benefits of hypothermia for the prevention of postoperative cognitive dysfunction (POCD) after cardiopulmonary bypass (CPB). One explanation for this might be that potentially injurious cerebral hyperthermia occurs during rewarming at the end of CPB, off-setting the protective benefits of hypothermia. In this study, we investigated the relative influence of CPB temperature, rewarming strategies, and postoperative temperature in a rat CPB model. ⋯ The combination of hypothermic (32 degrees C) CPB coupled with limited rewarming and prolonged postoperative hypothermia (35 degrees C) decreased POCD after CPB in rats.
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Anesthesia and analgesia · Mar 2008
Comment ReviewPreoperative coronary revascularization in high-risk patients undergoing vascular surgery: a core review.
Patients undergoing vascular surgery are at increased risk for cardiac complications related to the presence of underlying coronary artery disease. Preoperative cardiac evaluation may help to identify high-risk patients in whom coronary angiography may be planned with subsequent coronary revascularization for the purpose of improving perioperative and long-term cardiac outcomes. However, the indications and efficacy for type of revascularization for the reduction of cardiac complications compared to medical therapy has been controversial. My aim in this review is to summarize the role of preoperative revascularization compared to conservative medical therapy before elective vascular surgery using current evidence from published studies.
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Anesthesia and analgesia · Mar 2008
Randomized Controlled Trial Comparative StudyVasoconstriction and analgesic efficacy of locally infiltrated levobupivacaine for nasal surgery.
In this study, we compared the use of preincisional lidocaine 2% with epinephrine (LA) and levobupivacaine 0.25% plain (LB) for postoperative analgesia and vasoconstriction in patients undergoing nasal surgery. ⋯ We conclude that postoperative analgesia in nasal surgery with local infiltration of levobupivacaine was significantly more potent and longer lasting than that achieved by lidocaine plus epinephrine.
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Anesthesia and analgesia · Mar 2008
Randomized Controlled TrialThe role of a flash of light for attenuation of venous cannulation pain: a prospective, randomized, placebo-controlled study.
Venous cannulation is often performed without any analgesia, even though pain experienced during this procedure is at times very distressing. Various pharmacological and nonpharmacological measures have been tried with variable results to minimize venous cannulation pain. We designed the present study to evaluate the efficacy of a flash of light on attenuating venous cannulation pain. ⋯ We conclude that a flash of light before venous cannulation is a safe, effective, and easy-to-use method for minimizing venous cannulation pain.
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Anesthesia and analgesia · Mar 2008
Comparative StudyInteractive web simulation for propofol and fospropofol, a new propofol prodrug.
Using pharmacokinetic and pharmacodynamic data published in the scientific literature, we have developed interactive on-line simulations to model administration of propofol and fospropofol, a new water-soluble prodrug formulation of propofol. The prodrug formulation of fospropofol leads to a delayed onset to peak concentrations of propofol. A comparison simulation that overlays administration of fospropofol and propofol allows clinicians to understand the differences of administering fospropofol and traditional propofol. The simulations have the added advantage of allowing for differences among patients documented in test studies and the use of different models.