Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study
A randomized trial comparing prophylactic phenylephrine and ephedrine infusion during spinal anesthesia for emergency cesarean delivery in cases of acute fetal compromise.
Previous evidence showed that use of phenylephrine was associated with higher umbilical artery pH (UA pH) than ephedrine after elective cesarean delivery (CD). However, the best choice of vasopressor and its effect on funic gases in cases of acute fetal compromise require additional studies. ⋯ Our data report similar fetal acidosis with either phenylephrine or ephedrine administered during spinal anesthesia for treating maternal hypotension in cases of emergency CD.
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Recent health care policy changes promote objective measurements of patient satisfaction with care provided during hospitalization. Acute postsurgical pain is a significant medical problem and strongly impacts patient experience and patient satisfaction. Multimodal analgesic pathways are used for acute pain management, but opioid medications remain a mainstay of treatment. Opioid use is increasing in the outpatient setting, but opioid use trends in the inpatient postsurgical setting are not well known. We hypothesized that use of opioid medications has increased over time along with decrease in postoperative pain scores and increase in pain-related patient satisfaction. ⋯ In this retrospective cohort study, opioid use and pain-related patient satisfaction scores were stable over time. Pain-related patient satisfaction scores were negatively associated with both pain score and opioid dose. The associations we report should not be considered evidence of a causal relationship.
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Randomized Controlled Trial Comparative Study
Comparison of esophageal Doppler and plethysmographic variability index to guide intraoperative fluid therapy for low-risk patients undergoing colorectal surgery.
This study aims to investigate if there is equivalence in volumes of fluid administered when intravenous fluid therapy is guided by Pleth Variability Index (PVI) compared to the established technology of esophageal Doppler in low-risk patients undergoing major colorectal surgery. ⋯ PVI offers an entirely non-invasive alternative for goal-directed fluid therapy in this group of patients.
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Mask ventilation is one of the most important skills in airway management. Difficulty in mask ventilation can become life threatening if it is associated with difficulty in intubation during general anesthesia. We report a potential impossible ventilation condition which was safely and easily overcome with appropriate innovative modification of an Opsite adhesive film.
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Randomized Controlled Trial Comparative Study
Analgesic efficacy of pregabalin in acute postmastectomy pain: placebo controlled dose ranging study.
We hypothesized that oral administration of a single dose of pregabalin 2 hours before modified radical mastectomy (MRM) would produce dose-related reduction in postoperative opioid consumption. ⋯ A single preoperative oral dose of pregabalin 150 mg is an optimal dose for reducing postoperative pain and morphine consumption in patients undergoing MRM.