Anesthesia and analgesia
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There is growing interest in the use of regional anesthesia worldwide. With this survey, we determined the use of regional techniques among anesthesiologists in Nigeria using a cross-sectional study design. A self-administered questionnaire was mailed to a randomly generated list of anesthesiologists in Nigeria. ⋯ Regular use of spinal, epidural, and peripheral nerve blocks was 92.9%, 15%, and 2.9%, respectively. A high percentage of respondents (47.1%) had never performed a nerve block and only 31.4% had used a nerve stimulator technique. Limited exposure to equipment and techniques accounted for their lack of use.
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Anesthesia and analgesia · Jan 2010
Randomized Controlled Trial Multicenter Study Comparative StudySugammadex provides faster reversal of vecuronium-induced neuromuscular blockade compared with neostigmine: a multicenter, randomized, controlled trial.
Sugammadex, a specifically designed gamma-cyclodextrin, is a selective relaxant binding drug that rapidly reverses rocuronium-induced and, to a lesser extent, vecuronium-induced neuromuscular blockade. In this study, we compared the efficacy of sugammadex and neostigmine for the reversal of vecuronium-induced neuromuscular blockade in patients scheduled for elective surgery. ⋯ Sugammadex provided significantly faster reversal of vecuronium-induced neuromuscular blockade compared with neostigmine.
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Anesthesia and analgesia · Jan 2010
Randomized Controlled Trial Multicenter StudyA randomized, dose-response study of sugammadex given for the reversal of deep rocuronium- or vecuronium-induced neuromuscular blockade under sevoflurane anesthesia.
Sugammadex is the first of a new class of selective muscle relaxant binding drugs developed for the rapid and complete reversal of neuromuscular blockade induced by rocuronium and vecuronium. Many studies have demonstrated a dose-response relationship with sugammadex for reversal of neuromuscular blockade in patients induced and maintained under propofol anesthesia. However, sevoflurane anesthesia, unlike propofol, can prolong the effect of neuromuscular blocking drugs (NMBDs) such as rocuronium and vecuronium. ⋯ Sugammadex at doses of > or = 4 mg/kg provides rapid reversal of deep rocuronium- and vecuronium-induced neuromuscular blockade under sevoflurane maintenance anesthesia.
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Anesthesia and analgesia · Jan 2010
Randomized Controlled Trial Multicenter StudyMonitored anesthesia care with dexmedetomidine: a prospective, randomized, double-blind, multicenter trial.
Dexmedetomidine (DEX) is increasingly being used as a sedative for monitored anesthesia care (MAC) because of its analgesic properties, "cooperative sedation," and lack of respiratory depression. In this randomized, multicenter, double-blind, Phase III Food and Drug Administration study, we evaluated the safety and efficacy of two doses of DEX for sedation of patients undergoing a broad range of surgical or diagnostic procedures requiring MAC. ⋯ DEX is an effective baseline sedative for patients undergoing MAC for a broad range of surgical procedures providing better patient satisfaction, less opioid requirements, and less respiratory depression than placebo rescued with midazolam and fentanyl.
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Although cold hypersensitivity is a well-documented phenomenon in animals and humans with inflammatory and neuropathic pain, little is known about the presence of cold hyperalgesia after surgery. Therefore, we studied primary cold hyperalgesia after a surgical incision in mice. ⋯ The present data give strong evidence that a surgical incision does not cause cold hyperalgesia. Furthermore, a lack of cold hyperalgesia in unrestrained male and female mice after incision was not due to increased skin temperature after incision. Finally, we demonstrated that in contrast to a surgical incision, inflammation and nerve injury generate intense cold hyperalgesia and an increase in skin temperature, suggesting that different mechanisms are involved in surgical and inflammatory or neuropathic pain.