Anesthesia and analgesia
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Anesthesia and analgesia · Nov 2011
Brief report: The sensitivity of motor responses for detecting catheter-nerve contact during ultrasound-guided femoral nerve blocks with stimulating catheters.
We determined the sensitivity of motor responses evoked by stimulating catheters in determining catheter-nerve contact using ultrasonography as reference. ⋯ The absence of muscle responses at a stimulating current≤0.5 mA does not necessarily indicate the absence of catheter-nerve contact.
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Anesthesia and analgesia · Nov 2011
Randomized Controlled Trial Comparative StudyIntraperitoneal ropivacaine nebulization for pain management after laparoscopic cholecystectomy: a comparison with intraperitoneal instillation.
Studies evaluating intraperitoneal local anesthetic instillation for pain relief after laparoscopic procedures have reported conflicting results. In this randomized, double-blind study we assessed the effects of intraperitoneal local anesthetic nebulization on pain relief after laparoscopic cholecystectomy. ⋯ Intraperitoneal ropivacaine nebulization was associated with reduced shoulder pain and unassisted walking time but with an increased incidence of postoperative vomiting after laparoscopic cholecystectomy.
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Anesthesia and analgesia · Nov 2011
ReviewStatistical grand rounds: Importance of appropriately modeling procedure and duration in logistic regression studies of perioperative morbidity and mortality.
Multiple logistic regression studies frequently are performed with duration (e.g., operative time) included as an independent variable. We use narrative review of the statistical literature to highlight that when the association between duration and outcome is presumptively significant, the procedure itself (e.g., video-assisted thoracoscopic lobectomy or thoracotomy lobectomy) needs to be tested for inclusion in the logistic regression. ⋯ Only the scheduled duration is known when a patient would be randomized in a trial of preoperative or intraoperative intervention and/or meets with the surgeon and anesthesiologist preoperatively. By reviewing the literature about logistic regression and about predicting case duration, we show that the use of actual instead of scheduled duration can result in biased logistic regression results.