Anesthesia and analgesia
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Local anesthetic infiltration along the incision may be used to provide surgical anesthesia or postoperative analgesia. However, the effect of local anesthetics on wound healing remains controversial. In this investigation, we evaluated the effects of levobupivacaine on wound healing. ⋯ While levobupivacaine had a positive effect on wound healing during the early period, negative effects were observed thereafter. Additional studies at the molecular level are necessary to determine the cause of these apparently opposite effects.
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Anesthesia and analgesia · Feb 2013
Isometric force dynamometer is superior to bromage score in prediction of patients' ambulation after spinal anesthesia in ambulatory surgeries.
The aim of our study was to use a quantitative measure of muscle strength to identify the muscle power at which the patient can safely ambulate unassisted after spinal anesthesia. ⋯ Quantitative measurement of the degree of recovery of the motor power of the knee, hip, or ankle flexors is more accurate and superior to the qualitative Bromage score, as a predictor of the patient's ability to safely ambulate after spinal anesthesia. This may be recommended when assessing motor block when small-dose anesthetic solutions are used.
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Anesthesia and analgesia · Feb 2013
Physical exercise induces excess hsp72 expression and delays the development of hyperalgesia and allodynia in painful diabetic neuropathy rats.
The underlying mechanism of exercise on the development of diabetes-associated neuropathic pain is not well understood. We investigated in rats whether exercise regulates the functional recovery and heat shock protein 72 (Hsp72), tumor necrosis factor (TNF)-α, and interleukin (IL)-6 expression in streptozotocin (STZ)-induced diabetes. ⋯ These results suggest that progressive exercise training markedly decreases diabetes-associated neuropathic pain, including thermal hyperalgesia and mechanical allodynia. In rats, this protective effect is related to the increase of Hsp72, but not TNF-α and IL-6, expression in the spinal cord and peripheral nerves of STZ-induced diabetes.
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Anesthesia and analgesia · Feb 2013
Randomized Controlled TrialValidation of a mathematical model for ultrasound assessment of gastric volume by gastroscopic examination.
Pulmonary aspiration of gastric contents is a serious perioperative complication. Previous models of ultrasound gastric volume assessment are preliminary and have not been validated by an external "gold standard." In the present study we propose a more accurate model based on prospective data obtained from 108 patients undergoing bedside gastric sonography and upper gastrointestinal endoscopy (UGE). ⋯ We report a new prediction model to assess gastric fluid volume using standard 2-dimentional bedside ultrasound that has several advantages over previously reported models.