Anaesthesia and intensive care
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Anaesth Intensive Care · Mar 2009
Randomized Controlled Trial Comparative StudyA randomised, double-blind comparison of three different volumes of hypobaric intrathecal bupivacaine for orthopaedic surgery.
This study was designed to evaluate different doses of hypobaric 0.15% bupivacaine administered to achieve unilateral orthopaedic surgery under subarachnoid block. Using a randomised, double-blinded protocol, 150 ASA I to II patients scheduled for elective unilateral orthopaedic surgery were allocated to received a subarachnoid block with hypobaric bupivacaine 0.15% 4.5 mg (3 ml) (Group 1), 6.0 mg (4 ml) (Group 2) or 7.5 mg (5 ml) (Group 3). Measurements included cardiovascular and haemodynamic stability, incidence of unilateral anaesthesia, time to recover from motor block, postoperative urinary retention, transitory neurological symptoms and postdural puncture headache. ⋯ Seventy percent of patients had unilateral block. It was concluded that the spinal anaesthesia in all groups was suitable for single limb orthopaedic surgery. The smallest dose (4.5 mg) of hypobaric 0.15% bupivacaine resulted in more unilateral blocks, with narrower distribution and shorter duration.
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Anaesth Intensive Care · Mar 2009
Randomized Controlled TrialIntraoperative ketamine may influence persistent pain following knee arthroplasty under combined general and spinal anaesthesia: a pilot study.
We report the findings of a randomised controlled triple-blind pilot study of intraoperative ketamine infusion combined with spinal anaesthesia on the prevalence of persisting post surgical pain following total knee arthroplasty surgery. Twelve patients were randomised to receive either ketamine or placebo in association with spinal anaesthesia for total knee arthroplasty. ⋯ Perioperative data collected during the study suggested that the addition of intraoperative ketamine might also improve the quality of recovery. Although no statistical analysis was undertaken due to the small numbers, these preliminary findings suggest that the use of intraoperative systemic ketamine in association with spinal anaesthesia for the reduction of persisting post surgical pain deserves further study.