Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2016
Randomized Controlled Trial Multicenter StudyIncremental Value of Preoperative Copeptin for Predicting Myocardial Injury.
Copeptin, a novel marker of endogenous stress, has shown diagnostic and prognostic value in nonsurgical patients with a suspected coronary event. We aimed to assess the incremental value of copeptin in addition to established preoperative risk indices to predict the occurrence of postoperative myocardial injury. ⋯ Copeptin (≥9.6 pmol/L) was associated with significantly higher rates of myocardial injury and improved risk stratification in patients scheduled for noncardiac surgery with nonelevated preoperative troponin.
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Anesthesia and analgesia · Dec 2016
Review Meta AnalysisCombination of 5-HT3 Antagonist and Dexamethasone Is Superior to 5-HT3 Antagonist Alone for PONV Prophylaxis After Laparoscopic Surgeries: A Meta-analysis.
5-Hydroxytryptamine type 3 (5-HT3) receptor antagonists are the most commonly used drugs for postoperative nausea vomiting (PONV) prophylaxis. Dexamethasone is another antiemetic with proven efficacy in reducing PONV. The aim of this study was to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to compare the combination of dexamethasone and 5-HT3 antagonist versus a 5-HT3 antagonist alone as prophylaxis of PONV in laparoscopic surgical patients. ⋯ Combination of a 5-HT3 receptor antagonist and dexamethasone is significantly more effective than 5-HT3 antagonist alone in preventing PONV after laparoscopic surgeries, with possible improvement in postoperative analgesia.
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Anesthesia and analgesia · Dec 2016
ReviewInternet-Based Resources Frequently Provide Inaccurate and Out-of-Date Recommendations on Preoperative Fasting: A Systematic Review.
Preoperative fasting is important to avoid morbidity and surgery delays, yet recommendations available on the Internet may be inaccurate. Our objectives were to describe the characteristics and recommendations of Internet resources on preoperative fasting and assess the quality and readability of these websites. We searched the Internet for common search terms on preoperative fasting using Google® search engines from 4 English-speaking countries (Canada, the United States, Australia, and the United Kingdom). ⋯ Anesthesia society websites and scientific articles had higher DISCERN scores but worse readability compared with websites from health care institutions. Online fasting recommendations are frequently inconsistent with current guidelines, particularly among health care institution websites. The poor quality and readability of Internet resources on preoperative fasting may confuse patients.
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Anesthesia and analgesia · Dec 2016
Inhibition of Constitutive Nitric Oxide Synthase Does Not Influence Ventilation-Perfusion Matching in Normal Prone Adult Sheep With Mechanical Ventilation.
Local formation of nitric oxide in the lung induces vasodilation in proportion to ventilation and is a putative mechanism behind ventilation-perfusion matching. We hypothesized that regional ventilation-perfusion matching occurs in part due to local constitutive nitric oxide formation. ⋯ We found minimal or no influence of constitutive nitric oxide synthase inhibition by L-NAME on the distributions of ventilation and perfusion, and ventilation-perfusion in prone, anesthetized, ventilated, and healthy adult sheep with normal gas exchange.
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Anesthesia and analgesia · Dec 2016
The Effects of Electroacupuncture on the Apelin/APJ System in the Spinal Cord of Rats With Inflammatory Pain.
Electroacupuncture (EA) is widely applied for pain management, but the analgesic effects of EA have not been fully elucidated. In this study, we investigated the effect of EA on inflammatory pain caused by intraplantar injection of complete Freund's adjuvant (CFA) and apelin/APJ expression in the spinal cord of rats. ⋯ EA stimulation could alleviate inflammatory pain, at least in part, by restoring apelin and APJ mRNA and protein expression levels, which are downregulated in the CFA pain model.