Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 2014
Expected and experienced pain during epidural catheter insertion.
Insertion of an epidural catheter for pain relief is frequently used in anaesthetic practice. Little is known regarding patients' expected vs. experienced pain and discomfort due to the epidural block procedure. The purpose of this study was to investigate the expected and experienced pain, respectively, associated with the epidural procedure in patients undergoing major abdominal surgery. ⋯ Patients expect significantly more pain than they experience from receiving an epidural block.
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The work hours of Norwegian physicians are under scrutiny because of an increased public focus on patient safety. Ample international research indicate harmful effects of doctor fatigue based on studies on physicians working long weeks and on-call shifts of more than 30 consecutive hours. There is a lack of research on effects relevant for short or intermediate length of work weeks and call shifts. This study intended to study cognitive effects of short or intermediate duration in-hospital calls. ⋯ Reaction times were increased after 18 h night calls and non-significant increases in reaction times were apparent after the other on-call shifts. Self reported sleepiness was increased post-call. We were not able to conclude whether executive function or memory was negatively affected post-call.
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Acta Anaesthesiol Scand · Feb 2014
Components of pain assessment after laparoscopic donor nephrectomy.
Pain after laparoscopic surgery can be divided into three components: incisional or superficial wound pain, deep intra-abdominal pain and referred shoulder pain. Better understanding and adequate assessment of post-operative pain may be an important clue to the optimisation of recovery after laparoscopic surgery. Therefore, we performed a components of pain assessment after laparoscopic donor nephrectomy. ⋯ The components of pain assessment revealed that pain related to the Pfannenstiel incision and the deep intra-abdominal pain component are the most important determinants of pain after laparoscopic donor nephrectomy. Further improvement of the management of post-operative pain should focus on these components of pain.
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Acta Anaesthesiol Scand · Feb 2014
Endogenous amylin and glucagon-like peptide-1 concentrations are not associated with gastric emptying in critical illness.
In health, the hormones amylin and glucagon-like peptide-1 (GLP-1) slow gastric emptying (GE) and modulate glycaemia. The aims of this study were to determine amylin and GLP-1 concentrations in the critically ill and their relationship with GE, glucose absorption and glycaemia. ⋯ In the critically ill, fasting GLP-1, but not amylin, concentrations are elevated and associated with feed intolerance. Neither amylin nor GLP-1 appears to substantially influence the rate of GE.