Anesthesia and analgesia
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Anesthesia and analgesia · Jul 2008
Randomized Controlled TrialIntraarticular tramadol-bupivacaine combination prolongs the duration of postoperative analgesia after outpatient arthroscopic knee surgery.
Intraarticular (IA) local anesthetics are often used for the management and prevention of pain after arthroscopic knee surgery. Recently, IA tramadol was also used for the management of these patients. However, the IA combination of local anesthetic and tramadol has not been evaluated in arthroscopic outpatients. Our primary aim in this study was to evaluate the analgesic effect of an IA combination of bupivacaine and tramadol when compared with each drug alone using visual analog scale (VAS) pain scores in patients undergoing day-care arthroscopic knee surgery. Additionally, we assessed analgesic demand. ⋯ The IA admixture of tramadol 100 mg with bupivacaine 0.25% provides a pronounced prolongation of analgesia compared with either drug alone in patients undergoing day care arthroscopic knee surgery.
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Anesthesia and analgesia · Jul 2008
Randomized Controlled TrialListening to music during anesthesia does not reduce the sevoflurane concentration needed to maintain a constant bispectral index.
Music reduces stress responses in awake subjects. However, there remains controversy about the role of music or therapeutic suggestions during general anesthesia and postoperative recovery. We thus tested the hypothesis that intraoperative exposure to soothing music reduces the end-tidal concentration of sevoflurane (ETSevo) necessary to maintain bispectral index (BIS) near 50 during laparoscopic surgery. ⋯ The end-tidal concentration of sevoflurane required to maintain BIS near 50 during laparoscopic cholecystectomy was virtually identical in patients exposed to music or not. Although previous work suggests that music reduces preoperative stress and may be useful during sedation, our results do not support the use of music during surgery.
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Anesthesia and analgesia · Jul 2008
Randomized Controlled TrialThe role of postoperative neurocognitive dysfunction on quality of life for postmenopausal women 6 months after cardiac surgery.
Women are prone to neurological complications after cardiac surgery. We have previously reported that treatment perioperatively with the neuroprotectant steroid 17beta-estradiol did not improve neurocognitive end-points 4 to 6 wk after surgery for elderly women. In this study, we evaluated the influence of early postoperative neurocognitive dysfunction on quality of life in postmenopausal women undergoing cardiac surgery and whether it is impacted by perioperative 17beta-estradiol treatment. ⋯ Postoperative neurocognitive dysfunction is associated with impaired quality of life in women after cardiac surgery. Perioperative treatment with 17beta-estradiol provides no benefits to postoperative quality of life. The relationship between low preoperative and postoperative self-rated health status suggests that some aspects of quality of life in postmenopausal women are not amenable to improvements with cardiac surgery.
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Anesthesia and analgesia · Jul 2008
Randomized Controlled TrialThe effect of wound instillation of a novel purified capsaicin formulation on postherniotomy pain: a double-blind, randomized, placebo-controlled study.
Acute postoperative pain is common after most surgical procedures. Despite the availability of many analgesic options, postoperative pain management is often unsatisfactory. Purified capsaicin (ALGRX 4975 98% pure) has demonstrated prolong inhibition of C-fiber function in in vitro, preclinical, and clinical studies, and may be an effective adjunct to postoperative pain management. ⋯ In the setting of a well-defined analgesic protocol standard, VAS AUC analysis and a mixed-effect analysis showed superior analgesia of capsaicin relative to placebo during the first 3-4 days after inguinal hernia repair.
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Anesthesia and analgesia · Jul 2008
Cerebral microemboli during hip fracture fixation: a prospective study.
Recent studies have shown that cerebral fat microembolism takes place during surgery for hip or knee replacement. In this study, we examined the occurrence of cerebral microembolism, solid or gas, during a standard procedure of hip fracture fixation. ⋯ The incidence of cerebral microemboli during urgent surgery for hip fracture fixation is considerable. This phenomenon is not confined to hip or knee replacement surgery. The clinical implications of this finding require further investigation.