Journal of anesthesia
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Journal of anesthesia · Oct 2014
Randomized Controlled TrialIntrathecal ketorolac does not improve acute or chronic pain after hip arthroplasty: a randomized controlled trial.
Hypersensitivity to mechanical stimuli following surgery has been reported in patients who subsequently develop chronic pain after surgery. In animals, peripheral injury increases prostaglandin production in the spinal cord, and spinal cyclooxygenase inhibitors reduce hypersensitivity after injury. We therefore tested the hypothesis that spinal ketorolac reduces hypersensitivity and acute and chronic pain after hip arthroplasty ( www.clinicaltrials.gov NCT 00621530). ⋯ The groups did not differ in acute pain, acute opioid use, or pain incidence or severity at 2 and 6 months after surgery. There were no serious adverse events. Our results suggest that a single spinal dose of ketorolac does not substantially reduce acute surgical pain and is thus unlikely to reduce the risk of persistent incisional pain.
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Journal of anesthesia · Oct 2014
Randomized Controlled Trial Comparative StudyEffects of local infiltration analgesia for posterior knee pain after total knee arthroplasty: comparison with sciatic nerve block.
Although femoral nerve block provides good analgesia after total knee arthroplasty (TKA), residual posterior knee pain may decrease patient satisfaction. We compared the efficacy of periarticular infiltration analgesia (PIA) and sciatic nerve block (SNB) for posterior knee pain. ⋯ The combination of FNB and PIA provides sufficient analgesia after TKA. The rapid and convenient periarticular infiltration technique could be a good alternative to SNB.
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Journal of anesthesia · Oct 2014
Randomized Controlled Trial Comparative StudyDoes cuff pressure monitoring reduce postoperative pharyngolaryngeal adverse events after LMA-ProSeal insertion? A parallel group randomised trial.
The incidence of postoperative pharyngolaryngeal complications after laryngeal mask airway (LMA) insertion can be as high as 50%. Over-inflation of the LMA cuff may be a causal factor. We conducted a single-centre parallel group randomised trial to determine whether maintaining LMA-ProSeal intra-cuff pressures below 60 cm H2O decreases postoperative pharyngolaryngeal complications. ⋯ Our study failed to demonstrate a statistically significant reduction in postoperative pharyngolaryngeal complications by limiting intra-cuff pressures in the LMA-Proseal.
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Journal of anesthesia · Oct 2014
Impact of steroid medication before hospital admission on barotrauma in mechanically ventilated patients with acute respiratory distress syndrome in intensive care units.
To investigate the association between steroid medication before hospital admission and barotrauma in mechanically ventilated patients with acute respiratory distress syndrome (ARDS). ⋯ Barotrauma in ARDS patients was associated with higher pressure during mechanical ventilation but not with steroid medication before hospital admission.
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Journal of anesthesia · Oct 2014
Preventive effects of multisensory rehabilitation on development of cognitive dysfunction following systemic inflammation in aged rats.
Systemic inflammation can trigger transient or longer-lasting cognitive impairments, particularly in elderly patients. However, its pathogenesis has not been sufficiently clarified. In this study, we explored the potential effects of multisensory rehabilitation on cognitive dysfunction following systemic inflammation using an animal model. ⋯ These memory deficits were positively correlated with the levels of both tumor necrosis factor (TNF)-α and interleukin (IL)-1β in the hippocampus. On the other hand, in the LPS-treated ER group, neither cognitive impairment nor an increase in hippocampal levels of both TNF-α and IL-1β was found. These results imply that early rehabilitation (ER) intervention may be effective in preventing cognitive dysfunction following systemic inflammation via its anti-neuroinflammatory effects.