Anaesthesia
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We examined the pre-emptive analgesic effect of a cyclooxygenase (COX)-2 inhibitor in a rat surgical pain model and characterised the changes in cutaneous COX-2 around a surgical site. Thermal hyperalgesia and mechanical allodynia were tested in the rats for three days after incision and skin tissues were collected for analysis of COX-2. There was decreased expression of cutaneous COX-2 one day after surgical incision. Pre-incision injection of the COX-2 inhibitor significantly inhibited expression of COX-2 and also reduced thermal hyperalgesia (but not mechanical allodynia) compared with the post-incision COX-2-inhibitor injection group, one day after incision.
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Letter Case Reports
Tension gastrothorax presenting with dramatic ECG changes.
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Review Meta Analysis Comparative Study
A meta-analysis of the accuracy and precision of the ultrasonic cardiac output monitor (USCOM).
The ultrasonic cardiac output monitor is a non-invasive, continuous-wave Doppler monitor that can be used to measure cardiac output. Its accuracy and precision in peri-operative and critical care has been assessed with varied results. ⋯ The mean weighted bias was -0.39 l.min(-1) (95% CI -0.25 to -0.53 l.min(-1) ), precision 1.27 l.min(-1) and percentage error 42.7% (95% CI 38.5-46.9%). The ultrasonic cardiac output monitor achieved similar agreement with bolus thermodilution to that of other minimally invasive methods of peri-operative cardiac output monitoring, and may have a useful role in cardiac output monitoring.
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Randomized Controlled Trial Comparative Study
A randomised comparison of two intranasal dexmedetomidine doses for premedication in children.
We compared sedation levels in children following administration of intranasal dexmedetomidine. One hundred and sixteen children aged between 1 and 8 years were enrolled in this prospective, randomised trial. Children were assigned to receive either intranasal dexmedetomidine 1 μg.kg(-1) (Group 1) or 2 μg.kg(-1) (Group 2). ⋯ Both doses produced a similar level of satisfactory sedation in children aged 1-4 years, whereas 2 μg.kg(-1) resulted in a higher proportion of satisfactory sedation in children aged 5-8 years. There were no adverse haemodynamic effects. We conclude that intranasal dexmedetomidine in a premedication dose of 2 μg.kg(-1) resulted in excellent sedation in children.