Anesthesia and analgesia
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Anesthesia and analgesia · Mar 2010
Randomized Controlled Trial Comparative StudyLocal administration of morphine for analgesia after autogenous anterior or posterior iliac crest bone graft harvest for spinal fusion: a prospective, randomized, double-blind, placebo-controlled study.
Harvesting of iliac crest graft for spinal fusions is associated with a number of patients reporting residual or chronic pain at the harvest site. Various interventions, including morphine infiltration, have been proposed to minimize the associated pain. ⋯ This study has demonstrated that there are no additional benefits for the use of intraoperative infiltration of morphine into the iliac crest harvest site during spinal fusions.
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Anesthesia and analgesia · Mar 2010
Randomized Controlled TrialWhat does local tenderness say about the origin of pain? An investigation of cervical zygapophysial joint pain.
Mechanical pain sensitivity is assessed in every patient with pain, either by palpation or by quantitative pressure algometry. Despite widespread use, no studies have formally addressed the usefulness of this practice for the identification of the source of pain. We tested the hypothesis that assessing mechanical pain sensitivity distinguishes damaged from healthy cervical zygapophysial (facet) joints. ⋯ Assessing mechanical pain sensitivity is not diagnostic for cervical zygapophysial joint pain. The finding should stimulate further research into a diagnostic tool that is widely used in the clinical examination of patients with pain.
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Anesthesia and analgesia · Mar 2010
Multicenter StudyWhen blood is not an option: factors affecting survival after the use of a hemoglobin-based oxygen carrier in 54 patients with life-threatening anemia.
In consenting Jehovah's Witness patients and others for whom blood is contraindicated or not available, hemoglobin-based oxygen carrier (HBOC)-201 may enable survival in acutely anemic patients while underlying conditions are treated. ⋯ Earlier, compared with later, administration by inexperienced users of HBOC-201 to patients with anemia was associated with improved chances of survival of acutely bleeding and hemolyzing patients. Survival was more likely if the duration and magnitude of low hemoglobin was minimized before treatment with HBOC-201.
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Anesthesia and analgesia · Mar 2010
An anatomical basis for blocking of the deep cervical plexus and cervical sympathetic tract using an ultrasound-guided technique.
A selective blocking method for the cervical plexus and the cervical sympathetic trunk has not yet been established. ⋯ The longus capitis muscle is a suitable landmark for blocking the cervical plexus and trunk.
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Anesthesia and analgesia · Mar 2010
Randomized Controlled Trial Comparative StudyA comparison of 3% hypertonic saline and mannitol for brain relaxation during elective supratentorial brain tumor surgery.
In this study, we compared the effects of 3% hypertonic saline (HTS) and 20% mannitol on brain relaxation during supratentorial brain tumor surgery, intensive care unit (ICU) stays, and hospital days. ⋯ Our results suggest that HTS provided better brain relaxation than did mannitol during elective supratentorial brain tumor surgery, whereas it did not affect ICU stays or hospital days.