Articles: anesthetics.
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Orthopaedic surgery · Aug 2015
Randomized Controlled Trial Multicenter Study Comparative StudyIntra-articular Adjuvant Analgesics following Knee Arthroscopy: Comparison between Single and Double Dose Dexmedetomidine and Ropivacaine A Multicenter Prospective Double-blind Trial.
Knee arthroscopy is a commonly performed orthopedic procedure. Post-operatively, adequate pain relief reduces the surgical stress response and patient's morbidity and facilitates rehabilitation. The analgesic effect of dexmedetomidine (2 μg/kg body weight) as an adjunct to ropivacaine in knee arthroscopic knee procedures was studied to determine whether this would achieve longer post-operative analgesia and whether the study dosage of dexmedetomidine was safe and free of adverse effects. ⋯ Intra-articular dexmedetomidine (2 μg/kg) has superior analgesic efficacy, delayed the first postoperative requirement for analgesia and decreasing the need for postoperative analgesics with no major adverse effects.
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Randomized Controlled Trial Multicenter Study Comparative Study
Emergence times and airway reactions in general laryngeal mask airway anesthesia: study protocol for a randomized controlled trial.
The use of a laryngeal mask airway (LMA) in appropriate patients supports fast-track anesthesia with a lower incidence of postoperative airway-connected adverse events. Data on the most favorable anesthetic in this context, with the lowest rate of upper airway complications and fast emergence times, are controversial and limited. Desflurane seems to match these criteria best, but large randomized controlled trials (RCTs) with a standardized study protocol are lacking. Therefore, we aim to compare desflurane with other commonly used anesthetics, sevoflurane and propofol, in a sufficiently powered RCT. We hypothesize that desflurane is noninferior regarding the frequency of upper airway events and superior regarding the emergence times to sevoflurane and propofol. ⋯ Despite increasing importance of cost-effective and safe anesthesia application, we lack proof for the most advantageous anesthetic agent, when an LMA is used. There are only a few RCTs comparing desflurane to other commonly used anesthetics (sevoflurane, propofol and isoflurane) in patients with LMA. These RCTs were conducted with small sample sizes, huge interstudy variability, and some also showed strong biases. The present multicenter RCT will provide results from a large sample size with a standardized study protocol and minimized bias, which is feasible in the clinical routine. Furthermore, we will expand our knowledge regarding the most favorable recovery on the first postoperative day, which impacts patients' comfort after surgery.
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Reg Anesth Pain Med · Jul 2015
Randomized Controlled Trial Multicenter Study Comparative StudyA Randomized Comparison Between Single- and Triple-Injection Subparaneural Popliteal Sciatic Nerve Block.
This prospective randomized trial compared ultrasound-guided single-injection (SI) and triple-injection (TI) subparaneural popliteal sciatic nerve block. We hypothesized that multiple injections are not required when local anesthetic (LA) is deposited under the paraneurium because the latter entraps LA molecules, ensuring circumferential spread around the nerve. Therefore, in addition to comparable success rates, we also expected similar total anesthesia-related times (sum of performance and onset times) and designed this study as an equivalency trial. ⋯ Ultrasound-guided SI and TI subparaneural popliteal sciatic nerve blocks result in comparable success rates and total anesthesia-related times. Expectedly, the SI technique requires fewer needle passes.
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Reg Anesth Pain Med · Jul 2015
Multicenter Study Comparative StudyMedial Branch Blocks or Intra-Articular Injections as a Prognostic Tool Before Lumbar Facet Radiofrequency Denervation: A Multicenter, Case-Control Study.
Medial branch blocks (MBBs) and intra-articular (IA) facet joint injections are both used to diagnose facet joint pain and are presumed to be equivalent. No study has sought to determine which has a better prognostic value before radiofrequency (RF) denervation. ⋯ When used as a prognostic tool before lumbar facet radiofrequency, MBB may be associated with a higher success rate than IA injections. Our results should be confirmed by large, prospective, randomized studies.
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Multicenter Study Clinical Trial Observational Study
Predictors for postoperative nausea and vomiting after xenon-based anaesthesia.
The incidence of post-operative nausea and vomiting is about 30% lower following xenon anesthesia compared with traditional volatile anesthesia.
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