Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 2012
Review Meta AnalysisThe role of dexamethasone in the treatment of bacterial meningitis - a systematic review.
Corticosteroids are used as an adjunct to antibiotics in the treatment of bacterial meningitis in an attempt to attenuate the intrathecal inflammatory response and thereby reduce mortality and morbidity. The purpose of the present paper is to provide a review of clinical studies of corticosteroids in the treatment of bacterial meningitis. ⋯ Taken together, dexamethasone treatment may be associated with a lower mortality in adults and fewer neurological and auditory sequelae in adults and children from high-income countries, in particular in adults suffering from pneumococcal meningitis. In contrast, studies conducted in developing countries have yielded less favourable results.
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Acta Anaesthesiol Scand · Nov 2012
Randomized Controlled TrialThe perioperative combination of methadone and ketamine reduces post-operative opioid usage compared with methadone alone.
A synergy between ketamine and methadone (ME) to produce antinociception has been demonstrated in experimental neuropathy. We wanted to compare post-operative opioid requirements in patients undergoing multilevel lumbar arthrodesis after the administration combined ME-ketamine (MK) or ME alone. ⋯ Perioperative ketamine-ME combination significantly decreased opioid consumption by PCA.
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Acta Anaesthesiol Scand · Nov 2012
Viscoelastic and aggregometric point-of-care testing in patients with septic shock - cross-links between inflammation and haemostasis.
In the pathogenesis of sepsis, inflammation-induced changes in coagulation play a pivotal role. ⋯ Viscoelastic and aggregometric point-of-care testing was shown to be potentially useful for bedside diagnosis of sepsis. Moreover, viscoelastic and aggregometric point-of-care testing was able to determine the phase of septic coagulopathy (hypercoagulability vs. hypocoagulability) and therefore identified patients at high risk for overt disseminated intravascular coagulation.
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Acta Anaesthesiol Scand · Nov 2012
Clinical TrialPossible effects of mobilisation on acute post-operative pain and nociceptive function after total knee arthroplasty.
Experimental studies in animals, healthy volunteers, and patients with chronic pain suggest exercise to provide analgesia in several types of pain conditions and after various nociceptive stimuli. To our knowledge, there is no data on the effects of exercise on pain and nociceptive function in surgical patients despite early mobilisation being an important factor to enhance recovery. We therefore investigated possible effects of mobilisation on post-operative pain and nociceptive function after total knee arthroplasty (TKA). ⋯ This first exploratory hypothesis-generating pilot study suggests mobilisation to promote analgesic effects after TKA calling for future studies with a randomised, controlled design on exercise dose-response effects in post-surgical patients.
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Acta Anaesthesiol Scand · Nov 2012
Randomized Controlled TrialNaloxone infusion and post-hysterectomy morphine consumption: a double-blind, placebo-controlled study.
The evidence that an infusion of a low dose of naloxone reduces post-operative pain and opioid analgesic consumption is somewhat conflicting. Thus, the aim of the present study was to investigate the effect of an ultra-low dose of naloxone on patient-controlled morphine analgesia. ⋯ Following hysterectomy, an ultra-low dose of naloxone infusion proved to reduce morphine consumption as well as the incidence and severity of opioid-induced nausea and vomiting.