Anesthesia and analgesia
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Anesthesia and analgesia · Jun 2014
Randomized Controlled Trial Comparative StudyA randomized comparison between double-injection and targeted intracluster-injection ultrasound-guided supraclavicular brachial plexus block.
Ultrasound-guided supraclavicular block has faster onset when a targeted intracluster-injection technique is used compared with double injection.
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Anesthesia and analgesia · Jun 2014
Randomized Controlled TrialThe Effect of Single Low-Dose Dexamethasone on Blood Glucose Concentrations in the Perioperative Period: A Randomized, Placebo-Controlled Investigation in Gynecologic Surgical Patients.
The effect of single low-dose dexamethasone therapy on perioperative blood glucose concentrations has not been well characterized. In this investigation, we examined the effect of 2 commonly used doses of dexamethasone (4 and 8 mg at induction of anesthesia) on blood glucose concentrations during the first 24 hours after administration. ⋯ Because blood glucose concentrations during the first 24 hours after administration of single low-dose dexamethasone did not differ from those observed after saline administrations, these results suggest clinicians need not avoid using dexamethasone for nausea and vomiting prophylaxis out of concerns related to hyperglycemia.
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Anesthesia and analgesia · Jun 2014
Nanoanesthesia: A Novel, Intravenous Approach to Ankle Block in the Rat by Magnet-Directed Concentration of Ropivacaine-Associated Nanoparticles.
As an alternative to current methods of local nerve block, we studied the feasibility of producing ankle block in the rat with IV injection of magnetic nanoparticles (MNPs) associated with ropivacaine and application of a magnet at the ankle. ⋯ The current study establishes proof of principle that it is possible to produce ankle block in the rat by IV injection of MNP/Ropiv complexes and magnet application at the ankle. The results indicate that further study of this approach is warranted.
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Anesthesia and analgesia · Jun 2014
Death or Neurologic Injury After Tonsillectomy in Children with a Focus on Obstructive Sleep Apnea: Houston, We Have a Problem!
Obesity is epidemic in the United States and with it comes an increased incidence of obstructive sleep apnea (OSA). Evidence regarding opioid sensitivity as well as recent descriptions of deaths after tonsillectomy prompted a survey of all members of the Society for Pediatric Anesthesia regarding adverse events in children undergoing tonsillectomy. ⋯ Deaths or neurologic injury after tonsillectomy due to apparent apnea in children suggest that at least 16 children could have been rescued had respiratory monitoring been continued throughout first- and second-stage recovery, as well as on the ward during the first postoperative night. A validated pediatric-specific risk assessment scoring system is needed to assist with identifying children at risk for OSA who are not appropriate to be cared for on an outpatient basis.
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Anesthesia and analgesia · Jun 2014
Randomized Controlled TrialContinuous ultrasound-guided adductor canal block for total knee arthroplasty: a randomized, double-blind trial.
Adductor canal blocks have shown promise in reducing postoperative pain in total knee arthroplasty patients. No randomized, controlled studies, however, evaluate the opioid-sparing benefits of a continuous 0.2% ropivacaine infusion at the adductor canal. We hypothesized that a continuous adductor canal block would decrease postoperative opioid consumption. ⋯ A continuous adductor canal block for total knee arthroplasty reduces opioid consumption compared with that of placebo in the first 48 hours after surgery. Other outcomes including quadriceps strength, distance ambulated, and pain scores all show benefit from an adductor canal catheter after total knee arthroplasty but require further study before being interpreted as conclusive.