Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jan 2008
Randomized Controlled TrialEffect of preemptive epidural analgesia on cytokine response and postoperative pain in laparoscopic radical hysterectomy for cervical cancer.
Surgical stress and general anesthesia suppress immune function. Preemptive epidural analgesia can affect the perioperative immune responses, and influence cancer management. ⋯ Preemptive epidural analgesia is a reasonable approach for potentially controlling perioperative immune function and preventing postoperative pain in patients undergoing cancer surgery.
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Reg Anesth Pain Med · Jan 2008
Randomized Controlled TrialUse of a topical anesthetic cream (EMLA) to reduce pain after hemorrhoidectomy.
Hemorrhoidectomy usually leads to severe postoperative pain that often causes urinary retention. Topical EMLA cream (lidocaine 2.5% and prilocaine 2.5%) has been used extensively in the clinical setting. This prospective study tested the effectiveness of EMLA cream for postoperative pain control after hemorrhoidectomy. ⋯ Topical EMLA cream decreased pain intensity and meperidine requests, reduced the frequency of single catheterizations, and improved patient satisfaction with postoperative pain management after hemorrhoidectomy in adults.
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Reg Anesth Pain Med · Nov 2007
Randomized Controlled Trial Comparative StudyPostoperative epidural analgesia after total knee arthroplasty with sufentanil 1 microg/ml combined with ropivacaine 0.2%, ropivacaine 0.125%, or levobupivacaine 0.125%: a randomized, double-blind comparison.
Total knee replacement is associated with severe postoperative pain that, if treated insufficiently, interferes with early rehabilitation. The purpose of the present study is to compare the efficacy of ropivacaine (0.2% and 0.125%) and levobupivacaine (0.125%), all in combination with sufentanil 1 microg/mL with regard to postoperative pain relief and absence of motor block in a patient-controlled epidural analgesia setting. ⋯ All 3 solutions provided adequate analgesia and minimal motor block. The higher concentration of ropivacaine 0.2% was associated with a higher consumption of local anesthetic and did not result in a decrease in the consumption of sufentanil. Under the conditions of this study, patient-controlled epidural analgesia consumption of the epidural mixture was predominantly determined by sufentanil.
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Reg Anesth Pain Med · Nov 2007
Randomized Controlled TrialEffect of lumbar flexion on the extent of epidural blockade.
This study examined the effect of lumbar flexion on the extent of the epidural block during lumbar epidural anesthesia. ⋯ Lumbar flexion has no clinically relevant effect on sensory spread during epidural anesthesia.
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Reg Anesth Pain Med · Sep 2007
Randomized Controlled Trial Comparative StudyContinuous lumbar plexus block provides improved analgesia with fewer side effects compared with systemic opioids after hip arthroplasty: a randomized controlled trial.
A single injection lumbar plexus block for acute pain management after hip surgery is usually limited to the immediate postoperative period. We conducted a randomized controlled trial to determine the effect of a continuous lumbar plexus block on perioperative opioid requirements and pain intensity. ⋯ Continuous lumbar plexus block combined with PCA is superior to PCA alone for postoperative pain management following hip replacement. It reduces opioid requirements, opioid related side effects, and enhances patient satisfaction. However, additional research is required to determine its safety in light of the neurologic injury observed.