Regional anesthesia and pain medicine
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Reg Anesth Pain Med · May 2007
Randomized Controlled TrialA randomized controlled trial of the anticatabolic effect of epidural analgesia and hypocaloric glucose.
The goal of the present study was to investigate whether epidural analgesia exerts a protein-sparing effect after colorectal surgery in the presence of hypocaloric glucose supply initiated with surgical skin incision. ⋯ Epidural analgesia inhibits the increase in whole-body protein breakdown in patients receiving perioperative hypocaloric glucose infusion initiated with surgical skin incision. However, oxidative protein loss, protein synthesis, and glucose metabolism are not affected by epidural analgesia.
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Reg Anesth Pain Med · May 2007
Randomized Controlled TrialNausea, vomiting, sleep, and restfulness upon discharge home after outpatient anterior cruciate ligament reconstruction with regional anesthesia and multimodal analgesia/antiemesis.
We analyzed discharge outcome data after anterior cruciate ligament reconstruction (ACLR) under spinal anesthesia including a perineural femoral catheter and multimodal analgesia/antiemesis. The outcomes specifically addressed in this report are nausea, vomiting, and retching (NVR) and quality of sleep/difficulty falling asleep/daytime restfulness. ⋯ NVR and quality of sleep-restfulness after the described regional anesthetic with multimodal analgesia and antiemesis is reported. Smoking status was not a predictor of NVR, and gender and opioid consumption were not consistently predictive of NVR. The addition of a femoral nerve block to the described multimodal technique was not associated with NVR or quality of sleep-restfulness.
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Reg Anesth Pain Med · May 2007
Randomized Controlled TrialRebound pain scores as a function of femoral nerve block duration after anterior cruciate ligament reconstruction: retrospective analysis of a prospective, randomized clinical trial.
Continuous perineural femoral analgesia has been reported to reduce numeric rating pain scores (NRS, scale 0-10) after anterior cruciate ligament reconstruction (ACLR). In the current study, we determined rebound pain scores in autograft ACLR outpatients after nerve block analgesia resolved. ⋯ In an anesthesia care protocol consisting of spinal anesthesia and multimodal analgesia during and after autograft ACL reconstruction, approximately 33 hours of additional nerve block duration were required to reduce rebound pain scores by one unit. Further study is required to determine rebound pain score differences when other local anesthetics and anesthetic/analgesic plans are being used and when other surgeries are being performed.