British journal of anaesthesia
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Review Meta Analysis
Effects of acetaminophen on morphine side-effects and consumption after major surgery: meta-analysis of randomized controlled trials.
Acetaminophen is commonly used for the management of perioperative pain. However, there is a marked discrepancy between the extent to which acetaminophen is used and the available evidence for an analgesic effect after major surgery. The aim of this systematic review is to determine the morphine-sparing effect of acetaminophen combined with patient-controlled analgesia (PCA) with morphine and to evaluate its effects on opioid-related adverse effects. ⋯ Acetaminophen combined with PCA morphine induced a significant morphine-sparing effect but did not change the incidence of morphine-related adverse effects in the postoperative period.
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Case Reports
Dural ectasia: a likely cause of inadequate spinal anaesthesia in two parturients with Marfan's syndrome.
We report two cases of Caesarean section in patients with Marfan's syndrome where continuous subarachnoid anaesthesia failed to provide an adequate surgical block. This was possibly because of dural ectasia, which was confirmed by a computed tomography scan in both cases.
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There is strong evidence to suggest that anoxic depolarization (AD) is an important factor in hypoxia/ischaemia-induced neural damage. Treatments that prevent the occurrence of AD may be useful in providing neuronal protection against hypoxia. The current study was designed to determine whether general anaesthetics which have been suggested to 'induce prophylaxis' against hypoxia can attenuate the incidence of AD. ⋯ The prophylactic effect of thiopental against hypoxia might be induced, in part, by preventing the generation of AD.