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Randomized Controlled Trial Comparative Study
Randomized comparison of the Pentax AirWay Scope and Macintosh laryngoscope for tracheal intubation in patients with obstructive sleep apnoea.
Patients with obstructive sleep apnoea (OSA) can often present difficulties in intubation. This study aimed to compare the efficacy of the Pentax AirWay Scope (AWS) with that of the Macintosh laryngoscope for tracheal intubation in patients with OSA. ⋯ In this study of patients with OSA, tracheal intubation by experienced anaesthetists was facilitated using the Pentax AWS compared with the Macintosh laryngoscope.
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Reg Anesth Pain Med · Jul 2013
The impact of analgesic modality on early ambulation following total knee arthroplasty.
Total knee arthroplasty is associated with moderate to severe pain, and effective analgesia is essential to facilitate postoperative recovery. This retrospective cohort study examined the analgesic and rehabilitation outcomes associated with 48-hour continuous femoral nerve block, local infiltration analgesia, or local infiltration analgesia plus adductor canal nerve block. ⋯ Local infiltration analgesia was associated with improved early analgesia and ambulation. The addition of adductor canal nerve block was associated with further improvements in early ambulation and a higher incidence of home discharge.
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Integrating opioid risk and benefit into a single function may give a useful single measure of the opioid's positive and negative effects. An explorative study on the effects of fentanyl on antinociception and respiratory depression was performed to construct fentanyl risk-benefit (utility) functions. ⋯ Utility functions based on fentanyl's experimental effects on respiration and pain relief were successfully constructed. These functions are useful in multiple effect comparisons among experimental drugs. Further studies are required to assess whether this risk-benefit analysis is valuable in clinical practice.
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Endogenous TRPV1 agonists such as oxidized linoleic acid metabolites (OLAMs) and the enzymes releasing them [eg, cytochrome P450 (CYP)] are up-regulated after inflammation in the rat. However, it is not known whether such agonists are elevated in human inflammatory pain conditions. Because TRPV1 is expressed in human dental pulp nociceptors, we hypothesized that OLAM-CYP machinery is active in this tissue type and is increased under painful inflammatory conditions such as irreversible pulpitis (IP). ⋯ These data suggest that LA metabolites produced in human inflamed tissues act as TRPV1 agonists and that the metabolite production can be targeted by CYP inhibition. In addition, immunohistochemical analysis of 2 CYP isoforms, CYP2J and CYP3A1, were shown to be predominately expressed in immune cells infiltrating the inflamed dental pulp, emphasizing the paracrine role of CYP enzymes in OLAM regulation. Collectively, our data indicate that the machinery responsible for OLAM production is up-regulated during inflammation and can be targeted to develop potential analgesics for inflammatory-induced dental pain.
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Editorial Comment
A Race against Time: Planning Postoperative Critical Care.