Anesthesia and analgesia
-
Anesthesia and analgesia · May 2013
Randomized Controlled Trial Multicenter StudyNitrous oxide and serious morbidity and mortality in the POISE trial.
Nitrous oxide exposure was not associated with 30-day MI, stroke, death or hypotension in an observational analysis of POISE subjects.
pearl -
Anesthesia and analgesia · May 2013
Randomized Controlled Trial Comparative StudyA randomized comparison between bifurcation and prebifurcation subparaneural popliteal sciatic nerve blocks.
In this prospective, randomized, observer-blinded trial, we compared ultrasound-guided subparaneural popliteal sciatic nerve blocks performed either at or proximal to the neural bifurcation (B). We hypothesized that the total anesthesia-related time (sum of performance and onset times) would be decreased with the prebifurcation (PB) technique. ⋯ When local anesthetic is injected inside the paraneural sheath, B and PB posterior popliteal sciatic nerve blocks result in comparable success and total anesthesia-related times. However, in light of the 95% CIs, we cannot exclude the possibility that an intergroup difference of 19% and 7.83 minutes might have gone undetected for success rate and total time, respectively.
-
Anesthesia and analgesia · May 2013
Randomized Controlled TrialAn alternative distal approach for the lumbar medial branch radiofrequency denervation: a prospective randomized comparative study.
An alternative technique involving a "distal approach" can be used for lumbar medial branch radiofrequency denervation (LMBRFD). We described and assessed this technique by comparing it with a conventional tunnel vision approach in a prospective randomized trial. ⋯ Patients who underwent LMBRFD by the tunnel vision or distal approaches showed significant pain relief at the 6-month follow-up. Less periprocedural pain was reported in the distal approach group. We consider that the distal approach provides an improved option for LMBRFD.
-
Anesthesia and analgesia · May 2013
Randomized Controlled TrialThe hyperglycemic response to major noncardiac surgery and the added effect of steroid administration in patients with and without diabetes.
The pattern and magnitude of the hyperglycemic response to surgical stress, the added effect of low-dose steroids, and whether these differ in diabetics and nondiabetics remain unclear. We therefore tested 2 hypotheses: (1) that diabetics show a greater increase from preoperative to intraoperative glucose concentrations than nondiabetics; and (2) that steroid administration increases intraoperative hyperglycemia more so in diabetics compared with nondiabetics. ⋯ Treatment of intraoperative hyperglycemia should account for the hyperglycemic surgical stress response trend depending on the stage of surgery as well as the added effects of steroid administration. Denying steroid prophylaxis for postoperative nausea and vomiting for fear of hyperglycemic response should be reconsidered given the limited effect of steroids on intraoperative blood glucose concentrations.