Anesthesia and analgesia
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Anesthesia and analgesia · Oct 2010
Randomized Controlled Trial Comparative StudyDexmedetomidine infusion for analgesia and prevention of emergence agitation in children with obstructive sleep apnea syndrome undergoing tonsillectomy and adenoidectomy.
Dexmedetomidine, a specific α(2) agonist, has an analgesic-sparing effect and reduces emergence agitation. We compared an intraoperative dexmedetomidine infusion with bolus fentanyl to reduce perioperative opioid use and decrease emergence agitation in children with obstructive sleep apnea syndrome undergoing adenotonsillectomy (T&A). ⋯ An intraoperative infusion of dexmedetomidine combined with inhalation anesthetics provided satisfactory intraoperative conditions for T&A without adverse hemodynamic effects. Postoperative opioid requirements were significantly reduced, and the incidence and duration of severe emergence agitation was lower with fewer patients having desaturation episodes.
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Anesthesia and analgesia · Oct 2010
Randomized Controlled Trial Comparative StudyGoal-directed fluid management based on the pulse oximeter-derived pleth variability index reduces lactate levels and improves fluid management.
Dynamic variables predict fluid responsiveness and may improve fluid management during surgery. We investigated whether displaying the variability in the pulse oximeter plethysmogram (pleth variability index; PVI) would guide intraoperative fluid management and improve circulation as assessed by lactate levels. ⋯ PVI-based goal-directed fluid management reduced the volume of intraoperative fluid infused and reduced intraoperative and postoperative lactate levels.
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Anesthesia and analgesia · Oct 2010
Randomized Controlled Trial Comparative StudyIpsilateral transversus abdominis plane block provides effective analgesia after appendectomy in children: a randomized controlled trial.
The transversus abdominis plane (TAP) block provides effective postoperative analgesia in adults undergoing major abdominal surgery. Its efficacy in children remains unclear, with no randomized clinical trials in this population. In this study, we evaluated its analgesic efficacy over the first 48 postoperative hours after appendectomy performed through an open abdominal incision, in a randomized, controlled, double-blind clinical trial. ⋯ Unilateral TAP block, as a component of a multimodal analgesic regimen, provided superior analgesia compared with placebo in the first 48 postoperative hours after appendectomy in children.
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Anesthesia and analgesia · Oct 2010
Randomized Controlled Trial Comparative StudyThe influence of time of day of administration on duration of opioid labor analgesia.
Medications administered into the epidural or intrathecal space for labor analgesia may demonstrate variable effects dependent on time of day, and this may affect clinical research trials investigating the pharmacology of specific drugs. In this retrospective study, we evaluated the effect of time of day of administration of intrathecal fentanyl and systemic hydromorphone labor analgesia from data collected as part of a randomized clinical trial examining the influence of analgesia method on labor outcome. ⋯ Time of day of administration did not seem to influence combined spinal-epidural or systemic labor analgesia duration under these study conditions.
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Anesthesia and analgesia · Oct 2010
Randomized Controlled Trial Comparative StudyEffect on postoperative sore throat of spraying the endotracheal tube cuff with benzydamine hydrochloride, 10% lidocaine, and 2% lidocaine.
Postoperative sore throat (POST) is a common complication after endotracheal intubation. We compared the effectiveness on POST of spraying the endotracheal tube (ETT) cuff with benzydamine hydrochloride, 10% lidocaine, and 2% lidocaine. ⋯ Spraying benzydamine hydrochloride on the ETT cuff is a simple and effective method to reduce the incidence and severity of POST.