Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 2002
Estimating with confidence the risk of rare adverse events, including those with observed rates of zero.
Omission of a confidence interval (CI) associated with the risk of a serious complication can lead to inaccurate interpretation of risk data. The calculation of a CI for a risk or a single proportion typically uses the familiar Gaussian (normal) approximation. ⋯ Computer programs and simple equations are available to construct CIs reasonably accurately. In the special case in which the complication has not occurred, the risk estimated with 95% confidence is no worse than 3/n, where n is the number of trials.
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Reg Anesth Pain Med · Mar 2002
Randomized Controlled Trial Clinical TrialThe efficacy of continuous intrabursal infusion with morphine and bupivacaine for postoperative analgesia after subacromial arthroscopy.
The aim of this study was to determine whether an intrabursal morphine and bupivacaine mixed infusion provides useful analgesia for prolonged pain relief after subacromial arthroscopic operation. ⋯ The continuous intrabursal infusion method resulted in a decreased perception of rest pain and reduced supplemental analgesics requirement for 2 days postoperatively.
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Reg Anesth Pain Med · Mar 2002
Epidural analgesia and postoperative lipid metabolism: stable isotope studies during a fasted/fed state.
Although previous studies have reported an inhibitory effect of epidural block and glucose feeding on plasma concentrations of glycerol and free fatty acids (FFA), it remains unclear how epidural analgesia modifies the postoperative production and uptake of lipid metabolites. This can be achieved by determining the rate of lipolysis during a feeding state with dextrose. ⋯ The elevated rates of lipolysis associated with surgery cannot be suppressed by either epidural analgesia or dextrose feeding implying that the sustained stress response continues in the postoperative period and is the most important factor responsible for the increased release of glycerol.