Anesthesia and analgesia
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Anesthesia and analgesia · Nov 2009
Mild hypothermia has no long-term impact on postischemic neurogenesis in rats.
Postischemic improvement of functional outcome by therapeutic hypothermia may be related to cerebral regeneration by postischemic neurogenesis. We investigated whether mild peri-ischemic hypothermia leads to a long-term increase in postischemic neurogenesis. ⋯ Neither intraischemic nor postischemic hypothermia affected the ischemia-induced increase in endogenous neurogenesis. Intraischemic hypothermia reduced hippocampal damage, whereas postischemic hypothermia as applied here did not prevent formation of histopathological injury. This indicates that, 28 days after cerebral ischemia, postischemic neurogenesis is not significantly increased by mild peri-ischemic hypothermia and not affected by the severity of histopathological damage.
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Anesthesia and analgesia · Nov 2009
Randomized Controlled Trial Comparative StudyA comparison of gabapentin and ketamine in acute and chronic pain after hysterectomy.
Gabapentin and ketamine are popular analgesic adjuvants for improving perioperative pain management. We designed this double-blind, placebo-controlled study to test and compare the preventive effects of perioperative ketamine and gabapentin on early and chronic pain after elective hysterectomy. ⋯ Gabapentin and ketamine are similar in improving early pain control and in decreasing opioid consumption; however, gabapentin also prevented chronic pain in the first 6 postoperative months.
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Anesthesia and analgesia · Nov 2009
Randomized Controlled Trial Comparative StudyLow-dose 3 mg levobupivacaine plus 10 microg fentanyl selective spinal anesthesia for gynecological outpatient laparoscopy.
Lidocaine selective spinal anesthesia has been effective for short-duration gynecological outpatient laparoscopy. We compared the intraoperative effectiveness, anesthetic recovery times, and patient satisfaction after levobupivacaine-fentanyl versus lidocaine-fentanyl spinal anesthesia during short-duration gynecological laparoscopy. ⋯ Levobupivacaine 3 mg plus 10 microg fentanyl may be used as a suitable alternative to 10 mg lidocaine plus 10 microg fentanyl for spinal anesthesia of short duration. It achieved a clinically equivalent time for resolution of sensory block, similar intraoperative conditions, and comparable patient satisfaction..
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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
Late-onset ventilator-associated pneumonia in nontrauma intensive care unit patients.
Most studies designed to determine the factors associated with the acquisition of late-onset ventilator-associated pneumonia (VAP) were performed in critically ill trauma patients. The impact of enteral nutrition (EN) on the risk of acquiring VAP has been discussed. In this study, we assessed factors associated with late-onset VAP in nontrauma patients and determined whether nutrition provided early was associated with development of late-onset VAP in this population. ⋯ In our nontrauma patient population, early EN was not associated with development of late-onset VAP. In this population, severity of the disease during the first 5 days of MV seemed to be associated with late-onset VAP. In addition, our results suggest that the risk of late-onset VAP is higher in patients with a tube size >or=7.5 than in patients with a tube size <7.5.