Articles: anesthetics.
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Randomized Controlled Trial Multicenter Study Comparative Study
Cognitive deficit in first-time coronary artery bypass graft patients: a randomized clinical trial of lidocaine versus procaine hydrochloride.
Cognitive dysfunction increasingly has been recognized as a complication after cardiac surgery. Different methods have been considered for the reduction of cognitive dysfunction after cardiac surgery. One of these methods is by using lidocaine during surgery. The aim of this study was to determine the effects of adding lidocaine to the cardioplegia solution on cognitive impairment after coronary artery surgery. ⋯ Administration of lidocaine compared to that of procaine through the cardioplegia solution had a better effect on cognitive function after coronary artery bypass graft surgery.
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Multicenter Study
Propofol, the preferred sedation for screening colonoscopy, is underused. Results of an international survey.
The use of propofol during colonoscopy has become more widespread. To increase availability while maintaining quality and decreasing costs, European Guidelines have been issued for non-anesthesiologist administration of propofol (NAAP). We aimed to assess the current use of propofol during screening colonoscopy. ⋯ Propofol provides the highest endoscopist satisfaction but it is used in less than half of screening colonoscopies. Propofol is administered by non-anesthesiologists in one-third of settings; its implementation is foreseen by a majority of endoscopists who do not currently use it.
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The American surgeon · May 2012
Randomized Controlled Trial Multicenter StudyA double-blind, randomized, active-controlled study for post-hemorrhoidectomy pain management with liposome bupivacaine, a novel local analgesic formulation.
This randomized, active-controlled study evaluated the extent and duration of analgesia after administration of liposome bupivacaine (LB), a novel formulation of bupivacaine, compared with bupivacaine HCl given via local infiltration in excisional hemorrhoidectomy. One hundred patients were randomly assigned to receive a single dose of bupivacaine HCl 75 mg (0.25% with 1:200,000 epinephrine) or LB 66, 199, or 266 mg upon completion of hemorrhoidectomy. Postoperative pain intensity was assessed using a numeric rating scale at rest to calculate a cumulative pain score (area under the curve). ⋯ Median time to first opioid use was 19 hours for LB 266 mg versus 8 hours for bupivacaine HCl (P = 0.005). Incidence of opioid-related adverse events was 4 per cent for LB 266 mg compared with 35 per cent for bupivacaine HCl (P = 0.007). Local infiltration with LB resulted in significantly reduced postsurgical pain compared with bupivacaine HCl in patients after hemorrhoidectomy surgery.
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Chinese Med J Peking · Apr 2012
Multicenter Study Comparative Study Clinical TrialEvaluation of entropy for monitoring the depth of anesthesia compared with bispectral index: a multicenter clinical trial.
As a new electroencephalogram (EEG) signal processing technique for monitoring the depth of anesthesia, entropy consists of two indices: reaction entropy (RE) and state entropy (SE). Our study compared entropy with classical bispectral index (BIS) in reduction of myoelectrical interference and noxious stimuli with EEG signals. ⋯ This large-sample multicentric study confirmed the values of RE and SE as approximating BIS value, at the onset of unconsciousness during propofol TCI anesthesia. After elimination of myoelectrical activation, all values of RE, SE and BIS decreased significantly and the three indices were less sensitive to noxious stimuli than cardiovascular responses.
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ANZ journal of surgery · Apr 2012
Randomized Controlled Trial Multicenter StudySafety and efficacy of extended-release bupivacaine local anaesthetic in open hernia repair: a randomized controlled trial.
Pain relief remains a major problem in hernia surgery. SABER-Bupivacaine is an investigational extended-release formulation of bupivacaine in a resorbable matrix, which may provide up to 72 h of local pain relief. ⋯ After open inguinal hernia repair, SABER-Bupivacaine administered at the surgical site was safe and provided pain relief, reduced the need for supplemental (oral and parenteral) analgesia and did not impair wound healing.