Anesthesia and analgesia
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Anesthesia and analgesia · Apr 2008
Randomized Controlled TrialA prospective randomized trial on the role of perioperative celecoxib administration for total knee arthroplasty: improving clinical outcomes.
Total knee arthroplasty (TKA) is associated with considerable postoperative pain, which, if unrelieved, may result in prolonged hospital stay, inability to participate in rehabilitation programs, poor outcomes, and greater use of healthcare resources. The hypothesis of this study is that perioperative administration of celecoxib will improve analgesic efficacy, with a resultant improvement in short- and long-term clinical outcomes after TKA. ⋯ Perioperative use of celecoxib reduces postoperative pain, opioid consumption, opioid-related adverse effects, and is associated with long-term benefits including improved knee function and less time to achieve effective knee ROM after TKA.
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Anesthesia and analgesia · Apr 2008
Randomized Controlled TrialStimulating catheters for continuous femoral nerve blockade after total knee arthroplasty: a randomized, controlled, double-blinded trial.
Continuous femoral nerve blockade (CFNB) is often used for postoperative analgesia after total knee arthroplasty (TKA). CFNB can be instituted using a variety of techniques. Stimulating catheters (SC) have the advantage of confirming placement of the catheter close to the nerve during advancement. ⋯ In this study, blind catheter advancement was as reliable as a SC technique for establishing and maintaining CFNB for postoperative analgesia as a part of multimodal analgesia technique after TKA.
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Anesthesia and analgesia · Apr 2008
Randomized Controlled TrialSingle-dose dexamethasone reduces dynamic pain after total hip arthroplasty.
Preoperative glucocorticoids reduce postoperative nausea but may also improve analgesia and decrease opioid consumption. ⋯ A single, preoperative i.v. dose of dexamethasone 40 mg has a prolonged suppressive effect on the inflammatory response and decreases dynamic pain 24 h after total hip arthroplasty.
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Anesthesia and analgesia · Apr 2008
Randomized Controlled TrialA comparison of the end-tidal sevoflurane concentration for removal of the laryngeal mask airway and laryngeal tube in anesthetized children.
In this study we quantified and compared the optimal sevoflurane concentration required to prevent coughing or moving during or after removal of the laryngeal mask airway (LMA) and the laryngeal tube (LT) in anesthetized children. ⋯ LMA and LT removal in 95% of anesthetized children (aged 8 mo to 12 yr) can be safely accomplished without coughing, moving, or any other airway complications at 0.86 and 0.80 minimum alveolar anesthetic concentration, respectively, and a similar concentration should be used for removal of the LT or LMA in children.
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Anesthesia and analgesia · Apr 2008
Comparative StudyThe relationship between bispectral index and propofol during target-controlled infusion anesthesia: a comparative study between children and young adults.
In this prospective study, we compared the relationship between propofol concentrations and bispectral index (BIS) in children versus young adults anesthetized with target-controlled infusion (TCI) of propofol. ⋯ The good relationship between propofol and BIS demonstrated in children as in adults suggested a slightly lower sensitivity to propofol in children. As the predictability of plasma propofol concentrations with the classical pharmacokinetic/pharmacodynamic models is limited in children, a cerebral pharmacodynamic feedback, such as BIS, may be useful in this population.