British journal of anaesthesia
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In this study, we tested the reliability of a non-invasive finger-cuff-based continuous arterial blood pressure monitoring device (Nexfin, BMEYE, Amsterdam, NL) in critically ill surgical patients. ⋯ Non-invasive blood pressure monitoring with Nexfin does not seem to be sufficiently accurate to replace intra-arterial invasive blood pressure measurements in critically ill patients.
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Randomized Controlled Trial
Effect of concentration of local anaesthetic solution on the ED₅₀ of bupivacaine for supraclavicular brachial plexus block.
The aim of this trial was to compare the effect of concentration of bupivacaine solution on the ED₅₀ dose required for supraclavicular brachial plexus block. ⋯ Our study demonstrates that the ED₅₀ dose of bupivacaine for supraclavicular block is not dependent on the concentration. Lowering the concentration or the strength of the local anaesthetic leads to an increase in the volume required for successful block.
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Randomized Controlled Trial
Local infiltration analgesia for total knee arthroplasty: should ketorolac be added?
Adequate postoperative analgesia with minimal side-effects is essential for early mobilization and recovery in patients undergoing total knee arthroplasty (TKA). High-volume local infiltration analgesia (LIA) with ropivacaine has been introduced, but effects of adjuvants are still debated. We tested the hypothesis that the addition of ketorolac to LIA significantly improves analgesia after TKA. ⋯ LIA with ketorolac results in reduced morphine consumption, reduced pain intensity, and earlier readiness for hospital discharge.
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Randomized Controlled Trial
Oral choline supplementation for postoperative pain.
Activation of nicotinic receptors with nicotine has been shown to reduce post-surgical pain in clinical and preclinical studies. Choline is a selective agonist at α7-type nicotinic receptors that does not have addictive or sympathetic activating properties. It is anti-nociceptive in animal studies. We conducted a double-blind randomized trial of oral choline supplementation with lecithin to aid in the treatment of pain after gynaecological surgery. ⋯ Oral supplementation with lecithin during the perioperative period resulted in very slow absorption and thus only a small increase in plasma choline was achieved. This concentration was inadequate to reduce TNF as has been shown in other studies. The absence of an anti-inflammatory effect was likely related to our failure to demonstrate efficacy in pain reduction.