Anesthesia and analgesia
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Anesthesia and analgesia · Aug 1996
Randomized Controlled Trial Clinical Trial Retracted PublicationThe effects of albumin versus hydroxyethyl starch solution on cardiorespiratory and circulatory variables in critically ill patients.
Sufficient intravascular fluid therapy is of major importance in the treatment of the critically ill patient. The present study assessed whether the cardiorespiratory response of long-term volume replacement with low-molecular weight (LMW) hydroxyethyl starch solution (HES) differs from that of human albumin (HA). According to a randomized sequence, 30 trauma patients (injury severity score [ISS] between 15 and 30) and 30 sepsis patients (secondary to major general surgery) received either 10% HES (mean molecular weight 200,000 daltons; HES trauma [n = 15], HES sepsis [n = 15]) or human albumin 20% (HA trauma [n = 15], HA sepsis [n = 15]) over 5 days to keep pulmonary capillary wedge pressure (PCWP) between 12 and 18 mm Hg. ⋯ We conclude that long-term intravascular fluid therapy with HA in traumatized and sepsis patients has no advantages in comparison to LMW-HES. In both groups, volume replacement with HES even resulted in improved systemic hemodynamics. Decrease in pHi in the sepsis patients was blunted by HES infusion indicating improved splanchnic perfusion by this regimen of volume therapy.
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Anesthesia and analgesia · May 1996
Randomized Controlled Trial Clinical Trial Retracted PublicationPostarthroscopic meniscus repair analgesia with intraarticular ketorolac or morphine.
Both ketorolac, a nonsteroidal antiinflammatory drug, and morphine, an opioid agonist, provide enhanced patient analgesia after arthroscopic knee surgery when administered via the intraarticular route. This study was designed to determine whether ketorolac or morphine results in better patient analgesia and whether their combination would provide superior analgesia to either drug alone. Patients undergoing arthroscopic knee meniscus repair under local anesthesia with sedation were evaluated. ⋯ This study revealed a significant benefit from the individual intraarticular administration of both morphine and ketorolac. The combination of these drugs did not result in decreased postoperative pain or need for postoperative analgesics, and it did not result in an increased analgesic duration. We conclude that the use of either intraarticular ketorolac or intraarticular morphine improves the comfort in patients undergoing arthroscopic meniscus repair and that their combination offers no advantage over either drug alone.