Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2009
Randomized Controlled TrialA transdermal nicotine patch is not effective for postoperative pain management in smokers: a pilot dose-ranging study.
Nicotine has an antinociceptive effect in animal models. The analgesic effect in humans has been examined, but studies have had mixed results. A proposed etiology is variability in chronic nicotine exposure because of differences in tobacco smoking rates and second-hand smoke exposure. In this study, we examined the postoperative analgesic effect of a transdermal nicotine patch in smokers in a parallel design to a previous study in nonsmokers. ⋯ Transdermal nicotine, 5-15 mg, failed to relieve postoperative pain or reduce opioid use in smokers.
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Anesthesia and analgesia · Dec 2009
Comparative StudyA visual stethoscope to detect the position of the tracheal tube.
Advancing a tracheal tube into the bronchus produces unilateral breath sounds. We created a Visual Stethoscope that allows real-time fast Fourier transformation of the sound signal and 3-dimensional (frequency-amplitude-time) color rendering of the results on a personal computer with simultaneous processing of 2 individual sound signals. The aim of this study was to evaluate whether the Visual Stethoscope can detect bronchial intubation in comparison with auscultation. ⋯ During advancement of the tracheal tube, alterations of the shape of the visualized breath sounds using the Visual Stethoscope appeared before the changes of the breath sounds were detected by auscultation. Bilateral breath sounds disappeared when the tip of the tracheal tube was advanced beyond the carina in both groups.
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Anesthesia and analgesia · Dec 2009
Randomized Controlled Trial Comparative Study Retracted PublicationCardiopulmonary bypass priming using a high dose of a balanced hydroxyethyl starch versus an albumin-based priming strategy.
The optimal priming solution for cardiopulmonary bypass (CPB) is unclear. In this study, we evaluated the influence of high-volume priming with a modern balanced hydroxyethyl starch (HES) preparation on coagulation, inflammation, and organ function compared with an albumin-based CPB priming regimen. ⋯ High-volume priming of the CPB circuit with a modern balanced HES solution resulted in reduced inflammation, less endothelial damage, and fewer alterations in renal tubular integrity compared with an albumin-based priming. Coagulation including platelet function was better preserved with high-dose balanced HES CPB priming compared with albumin-based CPB priming.
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Anesthesia and analgesia · Dec 2009
Clinical TrialUltrasound-assisted and evoked motor response stimulation of the deep peroneal nerve.
We performed an observational volunteer study to document an ultrasound-guided evoked motor response blockade of the deep peroneal nerve. ⋯ Visualization of the deep peroneal nerve with ultrasound followed by elicitation of an evoked motor response, or paresthesia, predicts successful blockade of the deep peroneal nerve.