Anesthesia and analgesia
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Anesthesia and analgesia · Jun 2008
Review Meta AnalysisDoes supplemental oxygen reduce postoperative nausea and vomiting? A meta-analysis of randomized controlled trials.
Studies on the ability of supplemental oxygen to decrease the incidence of postoperative nausea and vomiting (PONV) are inconsistent, with initial studies suggesting benefit while subsequent trials demonstrate no decrease in PONV. ⋯ The positive results of two initial studies reducing the risk for PONV in patients given 80% Fio(2) were not confirmed by any of the subsequent trials. Considering all available evidence, 80% Fio(2) should no longer be considered an effective or reliable method to reduce overall PONV.
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Anesthesia and analgesia · Jun 2008
Randomized Controlled TrialDexmedetomidine infusion during laparoscopic bariatric surgery: the effect on recovery outcome variables.
Dexmedetomidine (Dex), an alpha(2) agonist, has well-known anesthetic and analgesic-sparing effects. We designed this prospective, randomized, double-blind, and placebo-controlled dose-ranging study to evaluate the effect of Dex on both early and late recovery after laparoscopic bariatric surgery. ⋯ Adjunctive use of an intraoperative Dex infusion (0.2-0.8 microg x kg(-1) x h(-1)) decreased fentanyl use, antiemetic therapy, and the length of stay in the PACU. However, it failed to facilitate late recovery (e.g., bowel function) or improve the patients' overall quality of recovery. When used during bariatric surgery, a Dex infusion rate of 0.2 microg x kg(-1) x h(-1) is recommended to minimize the risk of adverse cardiovascular side effects.
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Anesthesia and analgesia · Jun 2008
Randomized Controlled TrialClonidine and analgesic duration after popliteal fossa nerve blockade: randomized, double-blind, placebo-controlled study.
We tested the hypothesis that 100 microg clonidine added to 0.375% bupivacaine would prolong the duration of analgesia from popliteal fossa nerve blockade. ⋯ Clonidine significantly prolongs the analgesic duration after popliteal fossa nerve blockade with bupivacaine.
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Anesthesia and analgesia · Jun 2008
Randomized Controlled TrialPreoperative gabapentin prevents intrathecal morphine-induced pruritus after orthopedic surgery.
Pruritus is the most common side effect of intrathecal morphine. Gabapentin is an anticonvulsant and had been reported to be effective in some chronic pruritus conditions. Its effect in intrathecal morphine-induced pruritus has not yet undergone an evaluation. ⋯ Preoperative gabapentin prevents pruritus induced by intrathecal morphine in patients undergoing lower limb surgery with spinal anesthesia.
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Anesthesia and analgesia · Jun 2008
Randomized Controlled Trial Comparative StudyA comparison of intranasal dexmedetomidine and oral midazolam for premedication in pediatric anesthesia: a double-blinded randomized controlled trial.
Midazolam is the most commonly used premedication in children. It has been shown to be more effective than parental presence or placebo in reducing anxiety and improving compliance at induction of anesthesia. Clonidine, an alpha(2) agonist, has been suggested as an alternative. Dexmedetomidine is a more alpha(2) selective drug with more favorable pharmacokinetic properties than clonidine. We designed this prospective, randomized, double-blind, controlled trial to evaluate whether intranasal dexmedetomidine is as effective as oral midazolam for premedication in children. ⋯ Intranasal dexmedetomidine produces more sedation than oral midazolam, but with similar and acceptable cooperation.