Anesthesiology
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Randomized Controlled Trial Comparative Study
Lack of analgesia by oral standardized cannabis extract on acute inflammatory pain and hyperalgesia in volunteers.
Cannabinoid-induced analgesia was shown in animal studies of acute inflammatory and neuropathic pain. In humans, controlled clinical trials with Delta-tetrahydrocannabinol or other cannabinoids demonstrated analgesic efficacy in chronic pain syndromes, whereas the data in acute pain were less conclusive. Therefore, the aim of this study was to investigate the effects of oral cannabis extract in two different human models of acute inflammatory pain and hyperalgesia. ⋯ To conclude, no analgesic or antihyperalgesic activity of cannabis extract was found in the experiments. Moreover, the results even point to the development of a hyperalgesic state under cannabinoids. Together with previous data, the current results suggest that cannabinoids are not effective analgesics for the treatment of acute nociceptive pain in humans.
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Randomized Controlled Trial Comparative Study
Randomized controlled trial comparing adaptive-support ventilation with pressure-regulated volume-controlled ventilation with automode in weaning patients after cardiac surgery.
Adaptive-support ventilation (ASV) is a minute ventilation-controlled mode governed by a closed-loop algorithm. With ASV, tidal volume and respiratory rate are automatically adjusted to minimize work of breathing. Studies indicate that ventilation in ASV enables more rapid weaning. The authors conducted a randomized controlled trial to determine whether ventilation in ASV results in a shorter time to extubation than pressure-regulated volume-controlled ventilation with automode (PRVCa) after cardiac surgery. ⋯ ASV is associated with earlier extubation, without an increase in clinician intervention, when compared with PRVCa in patients undergoing uncomplicated cardiac surgery.
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Comparative Study
Total intravenous anesthesia including ketamine versus volatile gas anesthesia for combat-related operative traumatic brain injury.
Traumatic brain injury is a leading cause of death and severe neurologic disability. The effect of anesthesia techniques on neurologic outcomes in traumatic brain injury and potential benefits of total intravenous anesthesia (TIVA) compared with volatile gas anesthesia (VGA), although proposed, has not been well evaluated. The purpose of this study was to compare TIVA versus VGA in patients with combat-related traumatic brain injury. ⋯ Total intravenous anesthesia often including ketamine was not associated with improved neurologic outcome compared with VGA. Multiple confounders limit conclusions that can be drawn from this retrospective study.
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Randomized Controlled Trial Comparative Study
Lack of impact of intravenous lidocaine on analgesia, functional recovery, and nociceptive pain threshold after total hip arthroplasty.
The analgesic effect of perioperative low doses of intravenous lidocaine has been demonstrated after abdominal surgery. This study aimed to evaluate whether a continuous intravenous low-dose lidocaine infusion reduced postoperative pain and modified nociceptive pain threshold after total hip arthroplasty. ⋯ Low dose perioperative intravenous lidocaine after total hip arthroplasty offers no beneficial effect on postoperative analgesia and does not modify pressure and tactile pain thresholds.
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Randomized Controlled Trial Comparative Study
Randomized prospective study comparing the laryngeal tube suction II with the ProSeal laryngeal mask airway in anesthetized and paralyzed patients.
The Laryngeal Tube Suction II (LTSII; VBM, Medizintechnik, Sulz, Germany) is a recent revision of the Laryngeal Tube Suction. This study compared insertion and ventilation profiles of the LTSII and the ProSeal Laryngeal Mask Airway (PLMA; Laryngeal Mask Company, Henley-on-Thames, United Kingdom) in anesthetized and paralyzed patients. ⋯ Airway management with LTSII is inferior to that with PLMA.