Minerva anestesiologica
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Minerva anestesiologica · Apr 2011
Randomized Controlled TrialThe effects of physostigmine on recovery from general anesthesia in elderly patients.
Transient cognitive dysfunction after general anesthesia is a frequent finding among elderly patients. The aim of this study was to evaluate whether the use of physostigmine may enhance recovery from general anesthesia in elderly patients. ⋯ The intraoperative infusion of physostigmine enhances alertness, coordination, manual dexterity and mobilization after general anesthesia in elderly patients, but physostigmine administration does not affect orientation or sedation.
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Minerva anestesiologica · Apr 2011
Randomized Controlled TrialHigher postoperative pain and increased morphine consumption follow pre- rather than post-incisional single dose epidural morphine.
Neuraxial administration of morphine is an effective way of controlling postoperative pain and reducing analgesic consumption. Some animal models have demonstrated that preemptive administration of neuraxial narcotics reduces pain, while others have revealed the contrary. In addition, there have been no consistent results in clinical settings. This double-blind, randomized study compared the effects of pre- vs. post-incisional administration of neuraxial morphine on postoperative pain perception and analgesic requirements over 48 hours following laparotomy for open colectomy under standardized general anesthesia. ⋯ Pre-incisional epidural morphine in patients undergoing open colonic surgery under general anesthesia was associated with more postoperative pain, a greater need for analgesics, and poorer patient satisfaction compared to post-incisional morphine administration.