Anesthesia and analgesia
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Anesthesia and analgesia · Jun 2008
Randomized Controlled Trial Comparative StudyElectrical nerve stimulation or ultrasound guidance for lateral sagittal infraclavicular blocks: a randomized, controlled, observer-blinded, comparative study.
Ultrasound guidance is frequently used to perform infraclavicular brachial plexus blocks. In this study, we compared electrical nerve stimulation and ultrasound guidance for the lateral sagittal infraclavicular block. ⋯ We conclude that favorable results can be obtained when either nerve stimulation or ultrasound guidance is used for lateral sagittal infraclavicular block. Using ultrasound, local anesthetic injection cranioposterior to the artery appears feasible.
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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 TrialTransdermal oxygen does not improve sternal wound oxygenation in patients recovering from cardiac surgery.
Sternal wound dehiscence and infection complicate 1% of cardiac surgeries. Tissue oxygen tension (PsqO(2)) is the primary determinant of surgical wound infection risk and is often critically low in surgical incisions. We tested the hypothesis that local transdermal delivery of oxygen improves oxygenation in sternotomy wounds after cardiac surgery. Our secondary hypothesis was that supplemental inspired oxygen improves sternal wound PsqO(2). ⋯ Additional inspired oxygen improved Pao(2) and sternal wound PsqO(2) after bypass and may, consequently, reduce infection risk. However, oxygen insufflated locally into an occlusive dressing did not improve wound PsqO(2) and, therefore, does not appear to be useful clinically in cardiac surgery patients to reduce sternal wound infections.
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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.