Anesthesia and analgesia
-
Anesthesia and analgesia · Feb 2009
Review Meta AnalysisAwareness during anesthesia: risk factors, causes and sequelae: a review of reported cases in the literature.
Awareness during anesthesia is uncommon. The number of cases that are found in one single study are insufficient to identify and estimate the risks, causal factors and sequelae. One method of studying a large number of cases is to analyze reports of cases of awareness that have been published in scientific journals. ⋯ Our review suggested light anesthesia and a history of awareness as risk factors. Obesity and avoidance of nitrous oxide use did not seem to increase the risk. Light anesthesia was the most common cause. Our findings suggest preventive procedures that may lead to a decrease in the incidence of awareness.
-
Anesthesia and analgesia · Feb 2009
Randomized Controlled TrialA randomized, double-blind, controlled trial of perioperative administration of gabapentin, meloxicam and their combination for spontaneous and movement-evoked pain after ambulatory laparoscopic cholecystectomy.
Hysterectomy and spinal surgery inpatient trials suggest favorable interactions between cyclooxgenase-2 inhibitors and gabapentin/pregabalin on postoperative days 1-2. We present the first trial of meloxicam-gabapentin combination after outpatient laparoscopic cholecystectomy. ⋯ Although nausea was reduced with combination therapy, this trial provides little or no support for the combined use of meloxicam and gabapentin for pain relief on the day of surgery. This suggests that perioperative analgesic polypharmacy may not always be necessary or appropriate.
-
Anesthesia and analgesia · Feb 2009
Randomized Controlled Trial Comparative StudyUltrasound-guided anterior approach to sciatic nerve block: a comparison with the posterior approach.
Although the anterior approach to the sciatic nerve block has rarely been performed due to lack of reliable surface anatomical landmarks and technical difficulty, ultrasound guidance may make performance of this approach easier. In this study, we evaluated the clinical use of the ultrasound-guided anterior approach to sciatic nerve block and compared this approach with the posterior approach in adults. ⋯ The anterior approach to sciatic nerve block is performed as easily and successfully as the posterior approach using ultrasound guidance.
-
Anesthesia and analgesia · Feb 2009
Randomized Controlled Trial Comparative StudySpray-as-you-go airway topical anesthesia in patients with a difficult airway: a randomized, double-blind comparison of 2% and 4% lidocaine.
We designed this randomized, double-blind clinical study to compare the safety and efficacy of 2% and 4% lidocaine during airway topical anesthesia with a spray-as-you-go technique via the fiberoptic bronchoscope. ⋯ Both 2% and 4% lidocaine administered topically by a spray-as-you-go technique can provide clinically acceptable intubating conditions for awake FOI in sedated patients with a difficult airway. As compared with 4% lidocaine, however, 2% lidocaine requires a smaller dosage and results in lower plasma concentrations.