Anesthesia and analgesia
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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 Trial Comparative StudyPostoperative ketamine administration decreases morphine consumption in major abdominal surgery: a prospective, randomized, double-blind, controlled study.
Ketamine decreases postoperative morphine consumption, but its optimal dosing and duration of administration remain unclear. In this study, we compared the effects of ketamine administration on morphine consumption limited to the intraoperative period, or continued for 48 h postoperatively. ⋯ Low-dose ketamine improved postoperative analgesia with a significant decrease of morphine consumption when its administration was continued for 48 h postoperatively, with a lower incidence of nausea and with no side effects of ketamine.
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Anesthesia and analgesia · Jun 2008
Randomized Controlled Trial Comparative StudyEpiaortic scanning modifies planned intraoperative surgical management but not cerebral embolic load during coronary artery bypass surgery.
Patients with aortic atheroma are at increased risk for neurological injury after coronary artery bypass graft (CABG) surgery. We sought to determine the role of epiaortic ultrasound scanning for reducing cerebral embolic load, and whether its use leads to changes of planned intraoperative surgical management in patients undergoing CABG surgery. ⋯ These results show that the use of EAS led to modifications in intraoperative surgical management in almost one-third of patients undergoing CABG surgery. The use of EAS did not lead to a reduced number of TCD-detected cerebral emboli before or during CPB.
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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.