Anesthesia and analgesia
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Anesthesia and analgesia · Nov 2009
Randomized Controlled Trial Comparative StudyThe analgesic effect of gabapentin as a prophylactic anticonvulsant drug on postcraniotomy pain: a prospective randomized study.
Gabapentin is an anticonvulsant drug that has analgesic properties for acute postoperative pain. However, the analgesic effect of gabapentin as an antiepileptic prophylactic drug on patients undergoing craniotomy is unclear. In this study, we evaluated the postoperative effectiveness of gabapentin on acute postoperative pain when it is used for antiepileptic prophylaxis in patients undergoing craniotomy for supratentorial tumor resection. ⋯ The administration of gabapentin to patients undergoing craniotomy for supratentorial tumor resection was effective for acute postoperative pain. It also decreased analgesic consumption after surgery. However, it may lead to side effects such as delayed tracheal extubation and increased sedation postoperatively.
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Anesthesia and analgesia · Nov 2009
Multicenter StudyThe incidence of intraoperative awareness in children: childhood awareness and recall evaluation.
There is a considerable discrepancy between the reported incidences of awareness under anesthesia in children (0.2%-2.7%). In this prospective, observational, cohort study we evaluated 1) the incidence of awareness during general anesthesia in children across three settings, 2) factors contributing to awareness, and 3) short-term psychological effects of awareness. ⋯ Although 0.8% of children experienced possible/probable awareness in this study, none experienced short-term psychological distress.
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Anesthesia and analgesia · Nov 2009
Randomized Controlled Trial Comparative StudyA randomized comparison of low doses of hyperbaric bupivacaine in combined spinal-epidural anesthesia for cesarean delivery.
The aim of our study was to investigate the block characteristics of intrathecal hyperbaric bupivacaine 7, 8, or 9 mg administered during combined spinal-epidural anesthesia for cesarean delivery and to elucidate the dose that produces adequate sensory blockade for surgery while minimizing the incidence of hypotension, high neuroblockade, and the need for intraoperative epidural supplementation. ⋯ The lowest dose of hyperbaric bupivacaine (7 mg) provided equally rapid onset and effective anesthesia for cesarean delivery while reducing the incidence of hypotension compared with 8 and 9 mg. However, because of its shorter duration of anesthesia, it may be feasible only when the block can be reinforced using a functional epidural catheter.
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Anesthesia and analgesia · Nov 2009
Randomized Controlled Trial Comparative StudyThe effects of ultrasound guidance and neurostimulation on the minimum effective anesthetic volume of mepivacaine 1.5% required to block the sciatic nerve using the subgluteal approach.
We tested the hypothesis that ultrasound (US) guidance may reduce the minimum effective anesthetic volume (MEAV(50)) of 1.5% mepivacaine required to block the sciatic nerve with a subgluteal approach compared with neurostimulation (NS). ⋯ US provided a 37% reduction in the MEAV(50) of 1.5% mepivacaine required to block the sciatic nerve compared with NS.
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Anesthesia and analgesia · Nov 2009
Randomized Controlled TrialThe effectiveness of repetitive paravertebral injections with local anesthetics and steroids for the prevention of postherpetic neuralgia in patients with acute herpes zoster.
The treatment of postherpetic neuralgia (PHN) continues to be a challenge in clinical pain management. In this randomized, controlled study, we assessed the effectiveness of repetitive paravertebral injections with local anesthetics and steroids for the prevention of PHN in patients with acute herpes zoster. ⋯ Repetitive paravertebral anesthetic block in combination with steroids plus standard treatment with acyclovir and analgesics significantly reduced the incidence of PHN than the standard treatment alone.