Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
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Acta Anaesthesiol Taiwan · Sep 2012
Comparative StudyPatient-controlled analgesia (PCA) following video-assisted thoracoscopic lobectomy: comparison of epidural PCA and intravenous PCA.
To compare the efficacy and side effects of epidural patient-controlled analgesia (EPCA) with those of intravenous patient-controlled analgesia (IVPCA) in fast-track video-assisted thoracoscopic (VATS) lobectomy. ⋯ Our results indicated that the necessity of pain control was higher on POD1 for VATS lobectomy. Both EPCA and IVPCA can provide an adequate, continuous and effective means for postoperative pain management and a lower VAS-M was found in EPCA on POD2.
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Acta Anaesthesiol Taiwan · Sep 2012
Multicenter StudyAn open label trial of the effects and safety profile of extended-release tramadol in the management of chronic pain.
Tramadol is a synthetic centrally-acting opioid analgesic. The newly developed extended-release formulation of tramadol offers a more stable plasma concentration and could improve patients' compliance. The purpose of this study was to evaluate the efficacy, safety, and adverse events of extended release tramadol in Taiwanese patients with moderate to severe chronic noncancer pain. ⋯ Patients with chronic pain could obtain significantly better pain relief after the switch to larger doses of extended-release tramadol with safety and without severe adverse effects in a short period of time. Less severe adverse effects (no life-threatening event) was the leading cause of premature termination.
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Acta Anaesthesiol Taiwan · Sep 2012
Randomized Controlled TrialCombinations of fentanyl and levobupivacaine for post-thoracotomy pain.
The aim of the present study is to evaluate the analgesic activity, patient satisfaction, and side effect profile of different concentrations of levobupivacaine plus fentanyl administered through thoracic epidural patient-controlled analgesia in patients undergoing thoracotomy. The study included 60 patients who were randomly divided into three groups. At the end of the surgery, group I (n = 20) received 0.125% levobupivacaine plus 3 mg fentanyl, group II received 0.1% levobupivacaine plus 3 mg fentanyl, and group III received 0.05% levobupivacaine plus 3 mg fentanyl via an epidural catheter placed at the level of T(10-11) or T(11-12). ⋯ No side effects were encountered except mild nausea, which was seen in group III and did not require treatment. Motor blockage, pupil size, respiratory rate, and SpO(2) were not monitored in any of the patients in all groups. In conclusion, our study suggested that the use of 0.125% levobupivacaine, together with 3 mg/mL fentanyl, constitutes a good combination, and can be used safely without causing hemodynamic change and motor block.
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Acta Anaesthesiol Taiwan · Sep 2012
Perioperative transfusion-related acute lung injury: a retrospective analysis.
Transfusion-related acute lung injury (TRALI) is the leading morbidity and mortality in hemotherapy in the United States. Although it is a serious complication of blood transfusion, it is still underestimated and under-reported because of under-recognition and misdiagnosis. In this report, we present 15 surgical patients who developed pulmonary complications secondary to blood transfusion during the perioperative period. ⋯ TRALI must be recognized as one of the leading causes of mortality related to blood transfusion. Oxygen support is often sufficient in mild TRALI while ventilatory support is required in severe TRALI. The strategy to minimize such a risk using blood products from male donors or from female donors without history of pregnancy or having a negative leukocyte antibody screening can help reduce severe immune mediated TRALI.