Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jul 2000
Marked enhancement of anti-allodynic effect by combined intrathecal administration of the adenosine A1-receptor agonist R-phenylisopropyladenosine and morphine in a rat model of central pain.
There is often no satisfactory treatment for chronic pain after spinal cord injury. We have previously reported that intrathecal (i.t.) administration of the adenosine A1-receptor agonist R-phenylisopropyl-adenosine (R-PIA) or the opioid morphine has anti-allodynic effects in a model of presumed chronic central pain after photochemically induced spinal cord injury in rats. In the present study, we set out to investigate the possible interaction between i.t. R-PIA and morphine in spinally injured rats. ⋯ These results demonstrate a supra-additive interaction between the adenosine A1-receptor agonist R-PIA and morphine to reduce mechanical allodynia-like behavior in rats with chronic spinal cord injury. The combination of R-PIA and morphine administered spinally may be superior to R-PIA or morphine alone for treating such pain.
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Acta Anaesthesiol Scand · Jul 2000
Randomized Controlled Trial Clinical TrialEsmolol cardioplegia in unstable coronary revascularisation patients. A randomised clinical trial.
Esmolol has been studied and applied to control hypertension and tachycardia during open heart surgery. Esmolol has been used on a minor scale as a single cardioplegic agent. Little information is available on esmolol as a component of blood cardioplegia. In this prospective, randomised, double-blind clinical study we investigated whether esmolol improves cardioprotection in patients scheduled for an urgent coronary operation. ⋯ Esmolol addition to blood cardioplegia did not increase the efficacy of cardioprotection in the present study setting in unstable patients during urgent coronary revascularisation.
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Acta Anaesthesiol Scand · Jul 2000
Randomized Controlled Trial Meta Analysis Comparative Study Clinical TrialPostural post-dural puncture headache. A prospective randomised study and a meta-analysis comparing two different 0.40 mm O.D. (27 g) spinal needles.
To compare the incidence of postural post-dural puncture headache (PPDPH) after spinal anaesthesia using two different 0.40 mm O.D. (27 g) spinal needles: pencil-point needle and Quincke needle. In addition, a meta-analysis of studies comparing small bore spinal needles with regard to development of PPDPH was performed. ⋯ A pencil-point-shaped spinal needle will significantly reduce PPDPH compared with Quincke-type spinal needles, also when small bore needles (0.40 mm O.D.) are used.
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Acta Anaesthesiol Scand · Jul 2000
Clinical TrialPain intensity and side effects during titration of morphine to cancer patients using a fixed schedule dose escalation.
Considerable dose variations and frequent initial side effects have been postulated during start of morphine treatment to patients with pain caused by malignant disease. However, to our knowledge, only one previous study has reported effective doses in morphine naive cancer patients and no prospective evaluation has compared symptoms before with symptoms during morphine titration. ⋯ In cancer patients with uncontrolled pain on weak opioids, successful titration of morphine is achieved fast, with a three-fold morphine dose variation and with little increase in side effects.
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Acta Anaesthesiol Scand · Jul 2000
Randomized Controlled Trial Clinical TrialTopical tenoxicam from pharyngeal pack reduces postoperative sore throat.
One puff of beclomethasone inhaler has been shown to reduce the incidence of sore throat following endotracheal intubation. The aim of this study was to determine the effect of a pharyngeal pack on the incidence of sore throat and whether tenoxicam-impregnated gauze pack significantly influenced the frequency of sore throat. ⋯ The intraoperative use of a tenoxicam-impregnated gauze pack is effective in reducing moderate or severe postoperative sore throat following the use of throat pack.