Journal of anesthesia
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Journal of anesthesia · Aug 2014
Randomized Controlled TrialLateral Trendelenburg with the injected side down after the block improves the efficacy of the axillary approach to brachial plexus block.
We hypothesized that, after axillary block, positioning the patient in a lateral position with the injected side down and simultaneously in a 20° Trendelenburg position will increase the success rate and quality of the block. ⋯ We conclude that, for patients undergoing an axillary block, positioning the patient laterally with the injected side down and in a 20° Trendelenburg position increases the success rate and quality of the block.
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Journal of anesthesia · Aug 2014
Randomized Controlled Trial Comparative StudyUltrasound-guided sciatic nerve block: a comparison between four different infragluteal probe and needle alignment approaches.
Our aim was compare onset time of sciatic nerve blockade (SNB) performed distal to the subgluteal fold using four different ultrasound (US)-guided approaches in patients undergoing foot or ankle surgery. ⋯ The LA-IP approach resulted in a rapid onset of SNB and was associated with the best satisfaction for postoperative analgesia in comparison with LA-OP, SA-IP, and SA-OP approaches for patients undergoing foot and ankle surgery.
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Journal of anesthesia · Aug 2014
Randomized Controlled Trial Comparative StudyComparison of Siccoral(®) spray, Stomatovis (®) gargle, and Strefen (®) lozenges on postoperative sore throat.
Postoperative sore throat (POST) is a frequent complication caused by mucosal trauma to the pharyngeal, laryngeal, and tracheal airway after endotracheal intubation. We compared the effectiveness of Siccoral, Strefen, and Stomatovis treatments in alleviating POST. ⋯ Siccoral and Strefen can be effective in relieving POST in the early hours after extubation.
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Journal of anesthesia · Aug 2014
Randomized Controlled Trial Comparative StudyA randomised trial of oral versus intravenous opioids for treatment of pain after cardiac surgery.
Cardiac surgery and sternotomy are procedures accompanied by substantial postoperative pain which is challenging to treat. In general, intravenous (IV) opioids are used in the immediate postoperative phase, followed by oral opioids. Oral opioids are easier to use and generally less expensive. Our goal was thus to determine whether a new opioid preparation provides adequate analgesia after sternotomy. In particular, we tested the primary hypothesis that total opioid use (in morphine equivalents) is not greater with oral opioid compared with patient-controlled IV morphine. Our secondary hypothesis was that analgesic efficacy is similar with oral and IV opioids. ⋯ Analgesic quality was comparable with oral and IV opioids, suggesting that postoperative pain even after very painful procedures can be sufficiently managed with oral opioids.
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Journal of anesthesia · Aug 2014
Randomized Controlled TrialEffects of adding epinephrine on the early systemic absorption kinetics of local anesthetics in abdominal truncal blocks.
We evaluated the pharmacokinetics of ropivacaine following rectus sheath block (RSB) and transversus abdominis plane (TAP) block with or without epinephrine. A total of 26 adult patients undergoing lower abdominal surgery with RSB (=RSB trial) and another 26 adult patients undergoing open prostatectomy with TAP block (=TAP trial) were enrolled. ⋯ The peak concentration was significantly lower and time to peak concentration was significantly longer in the TAP-E(+) group than in the TAP-E(-) group (P < 0.05 and <0.01, respectively), while there were no significant differences in these parameters between the RSB-E(+) and RSB-E(-) groups. These results indicate that epinephrine attenuates the early phase of local anesthetic absorption from the injected site in TAP blocks, but not RSB.