Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 2011
Validation and usefulness of the Danish version of the Pain Medication Questionnaire in opioid-treated chronic pain patients.
Addiction is a feared complication of long-term opioid therapy for chronic pain patients. A screening tool to assess the potential risk of addiction may be helpful. ⋯ The PMQ may assist physicians in addiction risk assessment and stratification when treating chronic pain patients with opioids. PMQ is not a diagnostic tool and should only be used as an indicator for possible addiction problems.
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Acta Anaesthesiol Scand · Nov 2011
Randomized Controlled TrialDexamethasone has additive effect when combined with ondansetron and droperidol for treatment of established PONV.
Prophylactic dexamethasone, ondansetron and droperidol have a documented effect on post-operative nausea and vomiting (PONV). Still, there is a lack of studies investigating the effect of adding dexamethasone to ondansetron and droperidol in order to treat established PONV. ⋯ Treatment of established PONV comprising ondansetron and droperidol, with or without dexamethasone, reduced PONV in both treatment groups. In those reporting PONV without active prophylaxis, the addition of dexamethasone resulted in a significant amplification of the PONV-reducing [corrected] effects of ondansetron and droperidol.
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Acta Anaesthesiol Scand · Nov 2011
Sonoanatomy of the vasculature at the supraclavicular and interscalene regions relevant for brachial plexus block.
Our aim in this observational study was to utilize ultrasound, as well as anatomic dissection, to document the frequency with which branches of the subclavian vessels are found in close association with the brachial plexus at the locations of supraclavicular and interscalene brachial plexus block. ⋯ Small branch vessels from the subclavian artery and vein were frequently evident, on ultrasound imaging, in close association with the nerve elements of the brachial plexus in the supraclavicular and interscalene regions. Appreciation of the presence of these vessels and their likely origin and course will aid the anesthesiologist in planning a safe nerve block.
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Acta Anaesthesiol Scand · Nov 2011
Dexmedetomidine attenuates remote lung injury induced by renal ischemia-reperfusion in mice.
Renal ischemia-reperfusion (I/R) may cause acute lung injury (ALI). The mortality of combined acute kidney injury and ALI is extremely high. Dexmedetomidine, an α(2) adrenergic agonist, exerts potent anti-inflammatory and organoprotective effects in addition to its sedative and analgesic properties. We sought to elucidate whether dexmedetomidine can attenuate lung injury following renal I/R in a murine model of renal I/R. ⋯ Dexmedetomidine is capable of attenuating remote lung injury induced by renal IR via both α(2) adrenoceptors dependent and independent mechanisms.
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Acta Anaesthesiol Scand · Nov 2011
Noninvasive tissue oxygen saturation determined by near-infrared spectroscopy following peripheral nerve block.
Noninvasive physiologic measurement of cutaneous tissue oxygenation using near-infrared spectroscopy (NIRS) has become increasingly common in cardiovascular and plastic surgery. The aim of this study was to determine whether clinically available NIRS-based monitors could detect changes in tissue oxygen saturation (rSO(2)) following a variety of peripheral nerve blocks. We hypothesize that peripheral nerve blocks will produce detectable changes in cutaneous tissue oxygenation levels that can be measured by noninvasive NIRS-based oximetry. ⋯ Our results demonstrated sustained increases in tissue rSO(2) values following peripheral nerve block placement, in addition to higher initial rSO(2) values in operative limbs prior to block placement. Further investigations are necessary to define the expected baseline rSO(2) values in operative and control limbs. Future efforts utilizing NIRS-based detection of tissue ischemia should consider the small but significant changes in rSO(2) resulting from a successful nerve block.