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Journal of sleep research · Dec 2019
Randomized Controlled TrialSubjective sleep quality as a mediator in the relationship between pain severity and sustained attention performance in patients with fibromyalgia.
Pain severity and sleep are associated with cognitive performance in patients with fibromyalgia. This study examined whether sleep mediates the relationships of pain severity with psychomotor vigilance and attention in patients with fibromyalgia by analysing 80 patients with fibromyalgia. Cognitive performance, pain severity and sleep parameters were determined using the Psychomotor Vigilance Task, Brief Pain Inventory-Short Form and sleep diaries of seven consecutive nights, respectively. ⋯ In conclusion, sleep quality mediates the pain severity-cognitive performance relationship: pain affects sleep quality, which in turn impairs sustained attention. Our findings provide further insight into the processes underlying the relationship between pain and poor cognitive function. Improved sleep quality may offset the detrimental effects of pain on sustained attention.
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Randomized Controlled Trial Comparative Study
Preoperative oral dextromethorphan vs. clonidine to prevent tourniquet-induced cardiovascular responses in orthopaedic patients under general anaesthesia.
Preoperative oral dextromethorphan and intravenous clonidine attenuate arterial pressure and heart rate increases during tourniquet inflation under general anaesthesia. The effect of preoperative oral clonidine on these variables has not been investigated. ⋯ Preoperative oral clonidine 3 microg kg(-1) significantly prevented tourniquet-induced systemic arterial pressure increase in patients under general anaesthesia better than oral dextromethorphan.
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Randomized Controlled Trial Comparative Study
Anticholinergic premedication for flexible bronchoscopy: a randomized, double-blind, placebo-controlled study of atropine and glycopyrrolate.
Anticholinergic premedication is commonly used during flexible bronchoscopy, although the benefits are unproven and potential risks exist. ⋯ Anticholinergic premedication may reduce airway secretions during flexible bronchoscopy but is not associated with any significant reduction in cough, patient discomfort, oxygen desaturation, or procedure time and is associated with greater hemodynamic fluctuations. Routine anticholinergic premedication may be unnecessary or even harmful during flexible bronchoscopy.
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Randomized Controlled Trial Comparative Study
A trainee-based randomized comparison of stimulating interscalene perineural catheters with a new technique using ultrasound guidance alone.
Compared to the well-established stimulating catheter technique, the use of ultrasound guidance alone for interscalene perineural catheter insertion is a recent development and has not yet been examined in a randomized fashion. We hypothesized that an ultrasound-guided technique would require less time and produce equivalent results compared to electrical stimulation (ES) when trainees attempt interscalene perineural catheter placement. ⋯ Trainees using a new ultrasound-guided technique can place inter-scalene perineural catheters in less time compared to a well-documented technique using ES with a stimulating catheter and can produce equivalent results.
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Randomized Controlled Trial
Analgesic efficacy and safety of intravenous paracetamol (acetaminophen) administered as a 2 g starting dose following third molar surgery.
The recommended dose for intravenous (IV) paracetamol injection in adults is 1g, however pharmacokinetic and pharmacodynamic findings suggest that a better analgesia could be obtained with a 2 g starting dose. ⋯ The analgesic efficacy of a 2 g starting dose of IV paracetamol was superior over the recommended dose of 1g in terms of magnitude and duration of analgesic effect for postoperative pain following third molar surgery, with no significant difference between groups regarding safety.