Anesthesia and analgesia
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Anesthesia and analgesia · Feb 2010
Randomized Controlled TrialThe effects of nabilone on sleep in fibromyalgia: results of a randomized controlled trial.
Sleep disorders affect many patients with chronic pain conditions. Cannabis has been reported by several patient populations to help sleep. We evaluated the safety and efficacy of nabilone, a synthetic cannabinoid, on sleep disturbance in fibromyalgia (FM), a disease characterized by widespread chronic pain and insomnia. ⋯ Nabilone is effective in improving sleep in patients with FM and is well tolerated. Low-dose nabilone given once daily at bedtime may be considered as an alternative to amitriptyline. Longer trials are needed to determine the duration of effect and to characterize long-term safety.
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Anesthesia and analgesia · Feb 2010
Meta Analysis Comparative StudyStatistical modeling of average and variability of time to extubation for meta-analysis comparing desflurane to sevoflurane.
The recovery profile of an ideal anesthetic or technique would be fast (e.g., mean of 5 min from end of surgery to extubation) with little variability (e.g., always 4-7 min). We used anesthesia information management system (AIMS) data to learn how to model the time from end of surgery to extubation. We applied that knowledge for meta-analyses of trials comparing extubation times after use of desflurane and sevoflurane. ⋯ Desflurane reduces the average extubation time and the variability of extubation time by 20%-25% relative to sevoflurane. The principal economic value of these end points is their reductions of direct (labor) costs of OR time. However, reductions in intangible costs of prolonged extubation are real, being associated with subsequent delays. Reductions in the average and variance of times to extubation can be interpreted and monitored in terms of corresponding expected 75% reductions in the incidences of prolonged extubation times by using desflurane relative to sevoflurane.