Articles: anesthetics.
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Randomized Controlled Trial Multicenter Study
Intravenous Lidocaine for Gut Function Recovery in Colonic Surgery: A Randomized Clinical Trial.
Despite the recovery advantages of minimally invasive surgical techniques, delayed return of gut function after colectomy is a common barrier to timely discharge from hospital. ⋯ Among patients undergoing elective minimally invasive colon resection, perioperative administration of 2% intravenous lidocaine did not improve return of gut function at 72 hours.
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Reg Anesth Pain Med · Jan 2025
Crystallization of mixtures of local anesthetics with and without select adjuvants: a semiquantitative light microscopy analysis.
Injecting mixtures of local anesthetics with or without adjuvants is a common practise in regional and particularly obstetric anesthesia to decrease block onset time and/or augment epidural analgesia for cesarean section. While evidence on the efficacy of this practise is equivocal, little is known about its safety in terms of the pharmacologic compatibility of local anesthetics. ⋯ The preparation of local anesthetic (±adjuvant) mixtures leads to high grades of crystallization, which increase over 60 min and appear independent of solution pH. The risk of mixing medications with unknown physical or chemical compatibility profiles in regional anesthesia should be critically appraised and its clinical significance elucidated in future translational research.
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Randomized Controlled Trial Comparative Study
Intertransverse process block versus subcostal transversus abdominis plane block in patients undergoing laparoscopic radical gastrectomy: a prospective randomized controlled trial.
Laparoscopic radical gastrectomy has been reported to be associated with substantial trauma and pain. This study compared the impact of ultrasound-(US)-guided, bilateral, double-injection intertransverse process block (ITPB) on postoperative analgesia with subcostal transversus abdominis plane block (TAPB) in patients who were undergoing laparoscopic radical gastrectomy. ⋯ This study showed that the double-shot bilateral ITPB could reduce opioids consumption and achieve longer and better pain relief. Additionally, it promoted early postoperative activity and improved patient satisfaction.
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Prolonged tracheal extubation time is defined as an interval ≥ 15 min from the end of surgery to extubation. An earlier study showed that prolonged extubations had a mean 12.4 min longer time from the end of surgery to operating room (OR) exit. Prolonged extubations usually (57%) were observed during OR days with > 8 h of cases and turnovers, such that longer OR times from prolonged extubation can be treated as a variable cost (i.e., each added minute incurs an expense). The current study addressed limitations of the generalizability of these earlier investigations. ⋯ Matching earlier findings, prolonged tracheal extubation times are important economically, increasing OR time by 13 min and usually performed in ORs with lists of cases of sufficient duration to treat the extra time as a variable cost.
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Arch Orthop Trauma Surg · Jan 2025
Local infiltration anesthesia with high dose ropivacaine and dexmedetomidine in major knee surgery is safe.
The role of local infiltration anesthesia (LIA) in knee surgery is significant. LIA can be more potent than a nerve block, but without the downsides. A wide range of agents are used for LIA, including some off-label medications such as dexmedetomidine and ropivacaine. Dexmedetomidine has recently received attention for decreasing demand for anesthetic agents and prolonged effect of anesthesia. The purpose of this study was to demonstrate safety of dexmedetomidine and ropivacaine as LIA. ⋯ LIA in a combination of single high-dose ropivacaine and dexmedetomidine is safe in knee surgery. Further studies evaluating pain relief with this LIA combination are needed.