Anesthesia and analgesia
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Anesthesia and analgesia · Dec 1996
Detection of intraoperative segmental wall-motion abnormalities by transesophageal echocardiography: the incremental value of additional cross sections in the transverse and longitudinal planes.
Because biplane and multiplane transesophageal echocardiography (TEE) are more complex and expensive than single-plane TEE, we performed this study to determine whether the use of multiple single-plane (transverse) cross sections is as reliable for detection of left ventricular segmental wall-motion abnormalities (SWMA) as biplane TEE. We used biplane TEE to acquire nine standard cross sections of the left ventricle in 41 consecutive adults undergoing cardiac or vascular surgery. Six of these cross sections were in the transverse plane (i.e., achievable with single-plane TEE) and three in the longitudinal plane (i.e., achievable only with biplane or multiplane TEE). ⋯ Seventeen percent of all SWMA detected in this study were in the midpapillary transverse-plane cross section, an additional 48% in other transverse-plane cross sections, and 35% exclusively in the longitudinal-plane cross sections. Thus, most (65%), but not all, SWMA were in cross sections achievable with single-plane TEE. We conclude that the MP-T cross section should be the foundation for assessment of segmental function, but additional cross sections in the transverse and longitudinal planes are required for detection of the majority of segmental wall-motion abnormalities.
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Anesthesia and analgesia · Dec 1996
Randomized Controlled Trial Comparative Study Clinical TrialComparison of tenoxicam by intramuscular injection or wound infiltration for analgesia after inguinal herniorrhaphy.
We compared wound infiltration with small-dose tenoxicam (7.5 mg) to intramuscular (IM) administration of the same dose to treat pain after herniorrhaphy. In a randomized, double-blind study, 50 patients received either preoperative wound infiltration with tenoxicam, 7.5 mg in 40 mL of 0.9% saline (WI group; n = 25) or IM tenoxicam 7.5 mg (IM group; n = 25). In each group a saline placebo of equal volume was given by the alternate route, i.e., those who received wound infiltration with tenoxicam received 0.75 mL of 0.9% saline IM; those who received IM tenoxicam received 40 mL of 0.9% saline for wound infiltration. ⋯ The need for supplementary analgesics (acetaminophen and morphine) was registered. No differences were observed between groups in VAS pain scores, verbal rating pain scores, pain pressure thresholds, or in need for supplementary analgesics. We conclude that tenoxicam 7.5 mg has no local analgesic effect on postoperative pain after herniorrhaphy.