Anesthesia and analgesia
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Anesthesia and analgesia · May 2010
Randomized Controlled TrialLidocaine eye drops attenuate pain associated with ophthalmic postherpetic neuralgia.
Topical lidocaine (LDC) treatment using a gel or patch preparation is effective in the treatment of postherpetic neuralgia (PHN), but neither is suited for the eye in patients with ophthalmic PHN. Herein, we examined the effect of LDC 4% eye drops on ophthalmic PHN pain. ⋯ This study suggests that LDC provides a significant improvement of ophthalmic PHN because of its prompt analgesia, lack of systemic side effects, and convenience of use.
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Anesthesia and analgesia · May 2010
Randomized Controlled TrialSelective local anesthetic placement using ultrasound guidance and neurostimulation for infraclavicular brachial plexus block.
In this study, we performed the infraclavicular block with combined ultrasound guidance and neurostimulation to selectively target cords to compare the success rates of placing a single injection of local anesthetic either in a central or peripheral location. ⋯ Central placement of a single injection of local anesthetic targeted at the posterior cord resulted in a higher success rate for infraclavicular block.
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Anesthesia and analgesia · May 2010
Randomized Controlled TrialThe impact of timing of maximal crystalloid hydration on early graft function during kidney transplantation.
Early graft function is crucial for successful kidney transplantation. Maintaining adequate hydration is complicated by rapid movement of water to the extravascular space. We designed this study to test the effect of maximal hydration during graft ischemia time on early renal function. ⋯ Hydration directed toward maintaining a given CVP during kidney transplantation produced a more stable hemodynamic profile and promoted diuresis. The calculated infusion rate of approximately 45 to 50 mL . min(-1), within an hour ischemia time, seems feasible to enhance early graft function. A larger trial with long-term follow-up of renal function is warranted to confirm the clinical benefit of titrating IV crystalloid administration to maintain a given CVP in this population.
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Anesthesia and analgesia · May 2010
Randomized Controlled Trial Comparative StudyLevobupivacaine 0.5% provides longer analgesia after sciatic nerve block using the Labat approach than the same dose of ropivacaine in foot and ankle surgery.
Levobupivacaine and ropivacaine are 2 left enantiomeric molecules frequently used for peripheral nerve blocks because of their safe clinical profile. Levobupivacaine is more lipophilic and theoretically more potent than ropivacaine, but clinical studies show conflicting results in terms of anesthetic and analgesic characteristics. We hypothesized that the pure S-enantiomer of bupivacaine provides longer-lasting analgesia than ropivacaine. ⋯ Twenty milliliters levobupivacaine 0.5% in posterior gluteal (Labat) sciatic nerve block provided longer-lasting analgesia after foot and ankle surgery compared with the same dose of ropivacaine.
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Anesthesia and analgesia · May 2010
Randomized Controlled TrialGabapentin use in pediatric spinal fusion patients: a randomized, double-blind, controlled trial.
Gabapentin has opioid-sparing effects in adult surgical patients, but no reported studies have involved children and adolescents. In a double-blind, randomized, controlled trial, we examined whether gabapentin decreases postoperative opioid consumption for pediatric spinal fusion patients with idiopathic scoliosis. ⋯ Perioperative oral gabapentin reduced the amount of morphine used for postoperative pain after spinal fusion surgery, but not overall opioid-related side effects. Initial pain scores were lower in the treatment group. Perioperative use of gabapentin seems to be an effective adjunct to improve pain control in the early stages of recovery in children and adolescents undergoing spinal fusion.