Articles: anesthetics.
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Randomized Controlled Trial Multicenter Study Pragmatic Clinical Trial
The use of volatile anesthetic agents for long-term critical care sedation (VALTS): study protocol for a pilot randomized controlled trial.
Sedatives are administered to 85% of intensive care unit (ICU) patients. The most commonly used sedatives are intravenous benzodiazepines and propofol. These agents are associated with over-sedation in 40 to 60% of patients, which can lead to prolonged intubation, delirium and drug-induced hypotension. Evidence is increasing that volatile anesthetic agents are associated with faster extubation times, improved cardiovascular stability with no end-organ toxicity in comparison to our standard intravenous agents for short-term critical care sedation. Use of volatile agents within the ICU is a novel technique using a specialized delivery and scavenging system, which requires staff training and cultural acceptance. This pilot randomized controlled trial aims to assess the safety and feasibility of delivering volatile agents for long-term patient sedation in the ICU with limited or no experience of this technique. ⋯ This pilot project will serve as the basis for a larger RCT that will be powered for important clinical outcomes.
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Eur J Orthop Surg Tr · Dec 2015
Randomized Controlled Trial Multicenter Study Comparative StudyLocal infiltration analgesia versus continuous interscalene brachial plexus block for shoulder replacement pain: a randomized clinical trial.
Shoulder replacement involves significant post-operative pain, which is often managed by continuous interscalene brachial plexus block. Catheter displacement and complications limit the beneficial effect of the block. Local infiltration analgesia (LIA) has provided good results in knee replacement. We aimed to assess the effectiveness of LIA for pain after shoulder replacement. ⋯ The LIA technique cannot be recommended for shoulder replacement unless substantially modified. Occurrence of inadequate analgesia and complications following interscalene brachial plexus block prompt further studies into pain management after shoulder replacement.
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Acta Neurol. Scand. · Oct 2015
Randomized Controlled Trial Multicenter StudyGreater occipital nerve blockade for the treatment of chronic migraine: a randomized, multicenter, double-blind, and placebo-controlled study.
We aimed to assess the efficacy of greater occipital nerve (GON) blockade at chronic migraine (CM) treatment. ⋯ Our results suggest that GON blockade with bupivacaine was superior to placebo and was found to be effective, safe, and cost-effective for the treatment of CM. According to our knowledge, this is the first randomized, multicentre, double-blind, and placebo-controlled study in the literature in this field of work.
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Multicenter Study
General anaesthetic agents do not influence persistent pain after breast cancer surgery: A prospective nationwide cohort study.
It has recently been suggested that propofol exerts a protective effect on the occurrence of persistent pain after breast cancer surgery. We analysed data from a subcohort taken from a multicentre study to validate this information. ⋯ There does not appear to be a role for the anaesthetic protocol in the occurrence of persistent postsurgical pain. Other already well established hypotheses were confirmed.
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Randomized Controlled Trial Multicenter Study Comparative Study
Continuous Popliteal Sciatic Nerve Block Versus Single Injection Nerve Block for Ankle Fracture Surgery: A Prospective Randomized Comparative Trial.
To compare rebound pain and the need for narcotic analgesia after ankle fracture surgery for patients receiving perioperative analgesia through either a continuous infusion or a single injection nerve block. ⋯ Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.