Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2010
Randomized Controlled Trial Comparative StudyContinuous interscalene analgesia with ropivacaine 0.2% versus ropivacaine 0.3% after open rotator cuff repair: the effects on postoperative analgesia and motor function.
Interscalene analgesia is a recognized technique for the management of postoperative pain after major shoulder surgery. The most effective local anesthetic concentration in this setting is still controversial. In this study, we compared the analgesia and side effects of a continuous infusion of ropivacaine 0.2% and 0.3% administered through an interscalene catheter for the first 48 hours after surgery. ⋯ The use of ropivacaine 0.3% through an interscalene catheter for the first 48 hours after open rotator cuff repair provided a significant reduction of morphine consumption and a better sleep quality for the first postoperative night without increasing the intensity of motor block or side effects.
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Anesthesia and analgesia · Dec 2010
ReviewWhat's new in obstetric anesthesia in 2009? An update on maternal patient safety.
Every year, the Society of Obstetric Anesthesia and Perinatology nominates 1 individual to survey the prior year's literature and to identify the most notable articles for the science and practice of obstetric anesthesiology. This article reviews the 2009 literature, focusing on the theme of maternal patient safety, and advancing the notion of the obstetric anesthesiologist as both a perioperative and a peripartum physician. Three specific topics are reviewed: complications of obstetric anesthesia, general obstetric complications, and quality and safety in peripartum care.
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Anesthesia and analgesia · Dec 2010
Review Practice GuidelineSociety for Ambulatory Anesthesia consensus statement on perioperative blood glucose management in diabetic patients undergoing ambulatory surgery.
Optimal evidence-based perioperative blood glucose control in patients undergoing ambulatory surgical procedures remains controversial. Therefore, the Society for Ambulatory Anesthesia has developed a consensus statement on perioperative glycemic management in patients undergoing ambulatory surgery. A systematic review of the literature was conducted according the protocol recommended by the Cochrane Collaboration. ⋯ It was revealed that there is insufficient evidence to provide strong recommendations for the posed clinical questions. In the absence of high-quality evidence, recommendations were based on general principles of blood glucose control in diabetics, drug pharmacology, and data from inpatient surgical population, as well as clinical experience and judgment. In addition, areas of further research were also identified.
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Anesthesia and analgesia · Dec 2010
The association between lower extremity continuous peripheral nerve blocks and patient falls after knee and hip arthroplasty.
Continuous peripheral nerve blocks (CPNB) may induce muscle weakness, and multiple recently published series emphasize patient falls after postarthroplasty CPNB. However, none have included an adequate control group, and therefore the relationship between CPNB and falls remains speculative. ⋯ Our analysis suggests that there is a causal relationship between CPNB and the risk of falling after knee and hip arthroplasty.
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Anesthesia and analgesia · Dec 2010
Comparative StudyThe accuracy of noninvasive and continuous total hemoglobin measurement by pulse CO-Oximetry in human subjects undergoing hemodilution.
Total hemoglobin (tHb) is one the most frequently ordered laboratory measurements. Pulse CO-Oximetry™ (Masimo Corp., Irvine, CA) is a multi-wavelength spectrophotometric method for noninvasive and continuous hemoglobin monitoring (SpHb). In this study, we evaluated the accuracy of SpHb compared with laboratory CO-Oximeter measurement of tHb from arterial blood samples in 20 healthy volunteer subjects undergoing hemodilution. ⋯ Pulse CO-Oximetry-based SpHb measurement is accurate within 1.0 g/dL (1 SD) compared with laboratory CO-Oximeter tHb measurement in subjects undergoing hemodilution.