Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2009
Randomized Controlled TrialThe early and delayed analgesic effects of ketamine after total hip arthroplasty: a prospective, randomized, controlled, double-blind study.
Ketamine has been shown to have a morphine-sparing effect soon after surgery. Nevertheless, whether this effect still exists after being combined with nonsteroidal antiinflammatory drugs and acetaminophen, and whether ketamine can decrease chronic pain after nononcologic surgery remain unclear. Thus, we designed a study to assess ketamine's effect on acute and chronic postoperative pain when combined with multimodal analgesia after total hip arthroplasty (THA). ⋯ Ketamine had a morphine-sparing effect after THA, even when morphine was combined with multimodal systemic analgesia. It also facilitated rehabilitation at 1 mo and decreased postoperative chronic pain up to 6 mo after surgery.
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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
Randomized Controlled Trial Comparative StudyIncisional continuous fascia iliaca block provides more effective pain relief and fewer side effects than opioids after pelvic osteotomy in children.
Intravenous opioid therapy is frequently used for postoperative pain management in children after orthopedic surgery but causes side effects such as respiratory depression, vomiting, sedation, and urinary retention. To investigate whether a continuous incisional fascia iliaca compartment (FIC) block provides more effective postoperative pain relief with fewer side effects than IV morphine, we performed a prospective, double-blind, randomized study to compare both techniques. ⋯ Continuous incisional FIC block provides excellent postoperative pain relief, less sedation, and better return of appetite than morphine IV after pelvic osteotomy in children.
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Anesthesia and analgesia · Dec 2009
Randomized Controlled TrialThe effect of single-dose propofol injection on pain and quality of life in chronic daily headache: a randomized, double-blind, controlled trial.
On the basis of a small number of case studies, IV propofol has been advocated for the treatment of chronic daily headache (CDH). There has been no randomized controlled trial of this therapy. Our objective in this randomized, double-blind, placebo-controlled trial was to determine whether a single IV dose of propofol 2.4 mg/kg results in clinically significant reduction in disability or pain in CDH for the next 30 days. ⋯ A single IV infusion of propofol 2.4 mg/kg produces a statistically significant, but not clinically meaningful, reduction in disability from CDH 30 days after infusion and does not reduce pain intensity or analgesic use. This study does not support this regimen of IV propofol for clinical management of CDH.
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Anesthesia and analgesia · Dec 2009
Randomized Controlled Trial Multicenter Study Comparative StudyThe Flex-It stylet is less effective than a malleable stylet for orotracheal intubation using the GlideScope.
The GlideScope videolaryngoscope (Verathon Medical, Bothell, WA) usually provides excellent glottic visualization, but directing an endotracheal tube through the vocal cords can be challenging. The goal of the study was to compare the dedicated Flex-It stylet (FIS, Parker Medical, Highlands Ranch, CO) with a malleable stylet, as assessed by time to intubation (TTI). ⋯ In a group of experienced operators using the GlideScope, the FIS was less effective for orotracheal intubation than a malleable endotracheal tube stylet.