AANA journal
-
Randomized Controlled Trial Comparative Study
Comparison of fascia iliaca compartment block and 3-in-1 block in adults undergoing knee arthroscopy and meniscal repair.
Peripheral nerve blocks have become a popular method for treatment of pain after lower-extremity surgical procedures. Two peripheral nerve blocks for knee arthroscopy include the 3-in-1 block and the fascia iliaca compartment block (FICB). There is limited research comparing the efficacy of these blocks in adults undergoing knee arthroscopy and meniscal repair who receive both the peripheral nerve block and general anesthesia. ⋯ Patient satisfaction scores were similar between groups. Based on this study we recommend that the choice of block can be determined by the clinical scenario. We recommend a 3-in-1 block if speed of onset is the primary goal of anesthesia before induction, and we recommend the FICB block if prolonged postoperative analgesia is the primary goal.
-
Randomized Controlled Trial Comparative Study
Effects of using simulation versus CD-ROM in the performance of ultrasound-guided regional anesthesia.
The purpose of this study was to determine which method of teaching, CD-ROM, simulation, or a combination of both, was more effective in increasing the performance of ultrasound-guided regional anesthesia. No studies have investigated these methods. The framework for this study was critical thinking. ⋯ The means and standard deviations for pretest and posttest results, respectively, were: CD-ROM, 33 +/- 7%, 41 +/- 9%; simulation, 35 +/- 10%, 49 +/- 13%; and combination, 36 +/- 8%, 64 +/- 17%. The baseline for each group was 0. Use of a combination of CD-ROM and simulation should be considered in teaching ultrasound-guided regional anesthesia techniques.
-
Randomized Controlled Trial Controlled Clinical Trial
Effect of intraoperative intravenous lidocaine on postoperative pain and return of bowel function after laparoscopic abdominal gynecologic procedures.
Abdominal surgery has a high incidence of postoperative pain and dysfunctional gastrointestinal motility. This study investigated the effect of a continuous intraoperative infusion of lidocaine on patients undergoing laparoscopic gynecologic surgery. In this double-blind, placebo-controlled investigation, 50 subjects were randomly assigned to control and experimental groups. ⋯ Data were analyzed using descriptive and inferential statistics. A P value less than .05 was considered significant. These study results are consistent with previous research suggesting that intraoperative lidocaine infusion may improve postoperative pain levels and may shorten the time to return of bowel function.
-
Randomized Controlled Trial
Perioperative administration of gabapentin for shoulder arthroscopy: a prospective, randomized, double-blind, placebo-controlled study.
Recent studies suggest gabapentin has opioid-sparing effects and may reduce acute postoperative pain. However, there is limited research on the efficacy of gabapentin when combined in a multimodal approach after shoulder arthroscopy under general anesthesia with an interscalene block. We conducted prospective, double-blind study of 70 patients who were randomized to receive either 300 mg of gabapentin or placebo 1 hour before surgery, then twice a day for 2 days. ⋯ Total morphine equivalents on day 1 (gabapentin, 9.75 mg [6.58 mg], vs placebo, 9.52 mg [4.75 mg]; P = .88) and day 2 (gabapentin, 9.21 mg [6.66 mg], vs placebo, 6.93 mg [5.44 mg]; P = .17) were similar. Adverse effects and sleep patterns were similar (P > .05). These results suggest this dosing regimen of gabapentin is not efficacious in improving outcomes in patients undergoing shoulder arthroscopy under general anesthesia with an interscalene block.
-
Randomized Controlled Trial
Perioperative music and its effects on anxiety, hemodynamics, and pain in women undergoing mastectomy.
There is increasing interest in evaluating the use of nonpharmacologic interventions such as music to minimize potential adverse effects of anxiety-reducing medications. This study used a quasi-experimental design to evaluate the effects of a perioperative music intervention (provided continuously throughout the preoperative, intraoperative, and postoperative periods) on changes in mean arterial pressure (MAP), heart rate, anxiety, and pain in women with a diagnosis of breast cancer undergoing mastectomy. ⋯ Findings indicated that women in the intervention group had a greater decrease in MAP and anxiety with less pain from the preoperative period to the time of discharge from the recovery room compared with women in the control group. Music is a noninvasive and low-cost intervention that can be easily implemented in the perioperative setting, and these findings suggest that perioperative music can reduce MAP, anxiety, and pain among women undergoing mastectomy for breast cancer.