Journal of anesthesia
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Journal of anesthesia · Jan 2005
Randomized Controlled Trial Clinical TrialEffect of flumazenil on recovery from sevoflurane anesthesia in children premedicated with oral midazolam before undergoing herniorrhaphy with or without caudal analgesia.
Oral midazolam is frequently used to treat children, but its effect on recovery from anesthesia is controversial. This study was designed to evaluate the effect of flumazenil on reversal of midazolam during recovery from sevoflurane-induced anesthesia in children who underwent caudal analgesia compared to those who did not. ⋯ Caudal analgesia and avoiding the use of flumazenil synergistically resulted in the emergence from anesthesia in a less agitated state for children who underwent herniorrhaphy after oral midazolam premedication.
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Journal of anesthesia · Jan 2005
Randomized Controlled Trial Comparative Study Clinical TrialIs penile block better than caudal epidural block for postcircumcision analgesia?
To compare caudal and penile block for post-operative analgesia in children undergoing circumcision with respect to efficacy, complication rates, and parental satisfaction. ⋯ Penile and caudal block are equally effective for postcircumcision analgesia and neither is associated with serious complications. Anesthesiologist preference should be the deciding factor in choosing one technique over the other.
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Journal of anesthesia · Jan 2005
Randomized Controlled Trial Clinical TrialPatient-controlled epidural analgesia during labor using ropivacaine and fentanyl provides better maternal satisfaction with less local anesthetic requirement.
To test the hypothesis that patient-controlled epidural analgesia (PCEA) using ropivacaine and fentanyl provides better maternal satisfaction and less anesthetic requirement than conventional continuous epidural infusion (CEI) during labor, we studied 58 uncomplicated parturients (singleton, vertex presentation). ⋯ We found that PCEA was an effective means of providing optimal analgesia, with better satisfaction during labor and less local anesthetic requirement.
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Journal of anesthesia · Jan 2005
Randomized Controlled Trial Clinical TrialPain management after lumbar spinal fusion surgery using continuous subcutaneous infusion of buprenorphine.
The continuous subcutaneous infusion (CSI) technique is a simple, inexpensive method for managing postoperative pain. We examined the analgesic effects of CSI of buprenorphine in patients undergoing lumbar spinal fusion surgery. ⋯ CSI of buprenorphine effectively reduces pain after lumbar spinal fusion surgery without apparent side effects. This technique is simple and useful for postoperative pain management.
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Ischemic neuronal injury is characterized by early death mediated by excitotoxicity and by delayed death caused by apoptosis. Current evidence indicates that volatile agents, barbiturates, and propofol can protect neurons against ischemic injury caused by excitotoxicity. In the case of volatile agents and propofol, neuroprotection may be sustained if the ischemic insult is relatively mild; however, with moderate to severe insults, this neuronal protection is not sustained after a prolonged recovery period. ⋯ Cerebral ischemia is characterized by continued neuronal loss for a long time after the initial ischemic insult. Therefore, in investigations of cerebral ischemia, the duration of the recovery period should be taken into consideration in the analysis of the neuroprotective effects of anesthetic agents. A combination of different approaches that target specific stages of the evolution of ischemic injury may be required for sustained neuroprotection.