British journal of anaesthesia
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Clinical Trial Observational Study
Prediction of immediate postoperative pain using the analgesia/nociception index: a prospective observational study.
The analgesia/nociception index (ANI) is derived from heart rate variability, ranging from 0 (maximal nociception) to 100 (maximal analgesia), to reflect the analgesia/nociception balance during general anaesthesia. This should be correlated with immediate postoperative pain in the post-anaesthesia care unit (PACU). The aim of this study was to evaluate the performance of ANI measured at arousal from general anaesthesia to predict immediate postoperative pain on arrival in PACU. ⋯ ClinicalTrials.gov NCT01796249.
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Randomized Controlled Trial
Single-shot intraoperative local anaesthetic infiltration does not reduce morphine consumption after total hip arthroplasty: a double-blinded placebo-controlled randomized study.
The infiltration of local anaesthetic (LA), ketorolac, and epinephrine has been suggested to be effective for analgesia after total hip arthroplasty (THA). The part of action of each component of the mixture remains unclear. We investigated the contribution of infiltration of ropivacaine alone on the morphine consumption during the first 24 h after surgery. ⋯ Ropivacaine infiltration alone did not reduce morphine consumption at 24 h after operation nor did it improve postoperative rehabilitation.
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We report on a rare complication of poly(methyl methacrylate) (PMMA), injected into the spine, which then inadvertently leaked into the venous system. This resulted in an embolism of PMMA and produced a mass surrounding a triple lumen central venous catheter located in the superior vena cava. The catheter as well as the attached mass of PMMA was retrieved safely by cardiothoracic surgery. This case emphasizes the importance of prompt diagnosis and treatment and illustrates the need for close monitoring of patients undergoing any spinal surgery that includes vertebroplasty.