Anesthesia and analgesia
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Anesthesia and analgesia · Jan 2009
Case ReportsRoutine preoperative coagulation screening detects a rare bleeding disorder.
Factor X deficiency is a rare hereditary coagulation disorder. We report a case of congenital factor X deficiency diagnosed preoperatively in an 8-yr-old female child scheduled to undergo corrective surgery for congenital thoracolumbar kyphoscoliosis. Her preoperative coagulation profile revealed prolonged prothrombin time and activated partial thromboplastin time values. ⋯ IV tranexamic acid was also administered to reduce intraoperative blood loss. There were no postoperative bleeding complications. This case emphasizes the need for routine preoperative coagulation screening, at least for major surgical procedures.
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Anesthesia and analgesia · Jan 2009
Comparative StudyThe effects of smoking status on opioid tapering among patients with chronic pain.
The primary aim of this study was to determine if smoking status affected the ability of patients with chronic pain to reduce opioid consumption during a 3-wk pain rehabilitation program. Secondary aims included determining the associations between smoking status, admission opioid use, and pain severity. ⋯ For patients completing a pain rehabilitation program, most were able to eliminate opioid use, regardless of smoking status. However, significantly more smokers did not complete treatment. The most frequent reasons for program noncompletion included discrepant expectations of treatment, acute illness, and psychosocial stressors.
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Anesthesia and analgesia · Jan 2009
Comparative StudyThe feasibility of epicardial echocardiography for measuring aortic valve area by the continuity equation.
Measuring the aortic valve area (AVA) remains an important component of a comprehensive intraoperative echocardiographic examination in patients undergoing aortic valve surgery. Epicardial echocardiography (EE) represents an accessible alternative to transesophageal echocardiography (TEE), however, its agreement and correlation with other imaging modalities for measuring AVA has not been systematically validated. ⋯ EE measurements of AVA by the continuity equation show high agreement and closely correlate with established techniques of AVA assessment.
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Anesthesia and analgesia · Jan 2009
Comparative StudyBiochemical and biological properties of 4-(3-phenyl-[1,2,4] thiadiazol-5-yl)-piperazine-1-carboxylic acid phenylamide, a mechanism-based inhibitor of fatty acid amide hydrolase.
Fatty acid amide hydrolase (FAAH) is an integral membrane enzyme within the amidase-signature family. It catalyzes the hydrolysis of several endogenous biologically active lipids, including anandamide (arachidonoyl ethanolamide), oleoyl ethanolamide, and palmitoyl ethanolamide. These endogenous FAAH substrates have been shown to be involved in a variety of physiological and pathological processes, including synaptic regulation, regulation of sleep and feeding, locomotor activity, pain and inflammation. ⋯ The compound attenuates tactile allodynia in the rat mild thermal injury model of acute tissue damage and in the rat spinal nerve ligation (Chung) model of neuropathic pain. JNJ-1661010 also diminishes thermal hyperalgesia in the inflammatory rat carrageenan paw model. These data suggest that FAAH inhibitors with modes of action similar to JNJ-1661010 may be useful clinically as broad-spectrum analgesics.
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Anesthesia and analgesia · Jan 2009
Randomized Controlled TrialTramadol as an adjuvant to lidocaine for axillary brachial plexus block.
In this prospective randomized study, we evaluated the effect of tramadol as an adjuvant to axillary block. ⋯ The benefit of block prolongation associated with the addition of 200 mg tramadol to lidocaine during axillary block is limited by the slow onset of the block.