Anesthesiology
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Randomized Controlled Trial Multicenter Study
Reversal of profound, high-dose rocuronium-induced neuromuscular blockade by sugammadex at two different time points: an international, multicenter, randomized, dose-finding, safety assessor-blinded, phase II trial.
Sugammadex (Org 25969), a novel, selective relaxant binding agent, was specifically designed to rapidly reverse rocuronium-induced neuromuscular blockade. The efficacy and safety of sugammadex for the reversal of profound, high-dose rocuronium-induced neuromuscular blockade was evaluated. ⋯ Sugammadex provides a rapid and dose-dependent reversal of profound neuromuscular blockade induced by high-dose rocuronium (1.0 or 1.2 mg/kg) in adult surgical patients.
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Randomized Controlled Trial
Droperidol and ondansetron-induced QT interval prolongation: a clinical drug interaction study.
Droperidol and ondansetron have previously been found to prolong the QT interval in the treatment of postoperative nausea and vomiting. However, this adverse effect has never been confirmed and compared with both drugs under controlled conditions. The objective was to study the effects of droperidol and ondansetron alone or in combination on QT interval duration in healthy subjects. ⋯ Under controlled conditions, both droperidol and ondansetron either alone or in combination induced significant marked QTc interval prolongation. However, the combination of both drugs did not significantly increase QTc prolongation compared with that induced by droperidol alone.
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Randomized Controlled Trial
Remifentanil modifies the relation of electroencephalographic spectral changes and clinical endpoints in propofol anesthesia.
Depth-of-anesthesia monitoring with the electroencephalogram has become widely used in anesthesia practice. Generally, the methods presented are based on the spectral changes of the electroencephalogram. In this study, the authors evaluate the influence of remifentanil on the relation of timely occurrence of clinical endpoints and the spectral behavior of the electroencephalogram. ⋯ The infusion of remifentanil during propofol anesthesia significantly modifies the mutual relations of the electroencephalographic spectral characteristics and the endpoints in a predictable and quantifiable manner. This finding suggests that the electroencephalographic phenomena and the endpoints may not be identical but rather to some extent separate manifestations of hypnotic drug effect.
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Randomized Controlled Trial Multicenter Study
Randomized placebo-controlled study evaluating lateral branch radiofrequency denervation for sacroiliac joint pain.
Sacroiliac joint pain is a challenging condition accounting for approximately 20% of cases of chronic low back pain. Currently, there are no effective long-term treatment options for sacroiliac joint pain. ⋯ These results provide preliminary evidence that L4 and L5 primary dorsal rami and S1-S3 lateral branch radiofrequency denervation may provide intermediate-term pain relief and functional benefit in selected patients with suspected sacroiliac joint pain. Larger studies are needed to confirm these results and to determine the optimal candidates and treatment parameters for this poorly understood disorder.
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Randomized Controlled Trial
Morphine versus mexiletine for treatment of postamputation pain: a randomized, placebo-controlled, crossover trial.
Stump and phantom pains are debilitating sequelae of amputations that are often resistant to treatment. The efficacy of pharmacologic therapies, including opioids and sodium channel blockers, for postamputation pain is uncertain. ⋯ Therapy with morphine, but not mexiletine, resulted in a decrease in intensity of postamputation pain but was associated with a higher rate of side effects and no improvement in self-reported levels of overall functional activity and pain-related interference in daily activities.