Articles: postoperative.
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This review evaluates trials of antidepressants for acute and chronic postsurgical pain. ⋯ There is currently insufficient evidence to support the clinical use of antidepressants-beyond controlled investigations-for treatment of acute, or prevention of chronic, postoperative pain. Multiple positive trials suggest the therapeutic potential of antidepressants, which need to be replicated. Other nontrial evidence suggests potential safety concerns of perioperative antidepressant use. Future studies are needed to better define the risk-benefit ratio of antidepressants in postoperative pain management. Higher-quality trials should optimize dosing, timing and duration of antidepressant treatment, trial size, patient selection, safety evaluation and reporting, procedure specificity, and assessment of movement-evoked pain relevant to postoperative functional recovery.
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Acta Anaesthesiol Scand · Sep 2014
Impact of malnutrition on propofol consumption and recovery time among patients undergoing laparoscopic gastrointestinal surgery.
Malnutrition is a major health problem, especially in hospitalized patients as it can be closely related to many post-operative complications. However, research on malnutrition and its effect on the outcome of general anesthesia have been largely neglected. Here we investigated malnutrition status on propofol consumption and recovery time among patients undergoing laparoscopic gastrointestinal surgery under general anesthesia. ⋯ The present results indicate that the dosage and recovery time of propofol does change in malnourished individuals. Therefore, malnutrition may somehow affect the outcome of general anesthesia.
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Randomized Controlled Trial
Bispectral index guided titration of sevoflurane in on-pump cardiac surgery reduces plasma sevoflurane concentration and vasopressor requirements: A prospective, controlled, sequential two-arm clinical study.
Electroencephalographic-based monitoring systems such as the bispectral index (BIS) may reduce anaesthetic overdose rates. ⋯ BIS-guided titration of sevoflurane reduces the SPC and decreases noradrenaline administration compared with routine care during on-pump cardiac surgery.
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Achalasia is an idiopathic motility disorder causing progressive dysphagia and dilation of the esophagus. Rarely this esophageal dilation can cause acute respiratory insufficiency and/or failure. ⋯ Computed tomography of the chest performed for suspected pneumothorax revealed severe esophageal dilation with a mass effect. As this case describes, achalasia may present with the life-threatening complication of respiratory failure and requires a high index of suspicion for timely diagnosis and appropriate interventions.
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Sep 2014
Randomized Controlled TrialThe effect of a preoperative single-dose methylprednisolone on postoperative pain after abdominal hysterectomy: a randomized controlled trial.
Methylprednisolone has been shown to have analgesic effects after orthopedic surgery. The objective of this trial was to compare the effect of 125 mg methylprednisolone with placebo on postoperative pain after abdominal hysterectomy. ⋯ ClinicalTrial.gov: www.clinicaltrials.gov: NCT01106547.