Anesthesia and analgesia
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Anesthesia and analgesia · Jun 2006
Randomized Controlled TrialIntraoperative administration of tramadol for postoperative nurse-controlled analgesia resulted in earlier awakening and less sedation than morphine in children after cardiac surgery.
In adults, intraoperative administration of tramadol could result in earlier recovery and less sedation than morphine. In this controlled, randomized, double-blind study, we investigated whether an intraoperative initial dose of tramadol could cause more rapid awakening from general anesthesia, less sedation, and earlier tracheal extubation than morphine in children during the immediate postoperative period. Forty children aged 1-6 yr, scheduled for atrial or ventricular septal defect repair and tracheal extubation in the pediatric intensive care unit, were randomly allocated to receive morphine, initial dose 0.2 mg/kg, or tramadol 2 mg/kg given at the end of sternal closure, followed by nurse-controlled analgesia (bolus 0.02 mg/kg of morphine and 0.2 mg/kg of tramadol) with background infusions (0.015 mg x kg(-1) x h(-1) for morphine and 0.15 mg x kg(-1) x h(-1) for tramadol). ⋯ Times to first trigger of nurse-controlled analgesia bolus and objective pain scores during the 48 h observation period were comparable between groups. The incidence of desaturation and emesis were similar between groups. The patients ate well and did not differ on Day 1 or Day 2.
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Anesthesia and analgesia · Jun 2006
Randomized Controlled TrialN-acetylcysteine for the prevention of kidney injury in abdominal aortic surgery: a randomized, double-blind, placebo-controlled trial.
In this prospective, randomized, placebo-controlled, double-blind trial we studied the effects of IV N-acetylcysteine for prevention of renal injury in patients undergoing abdominal aortic surgery. Seventy patients without previously documented renal dysfunction were randomly allocated to receive either N-acetylcysteine (150 mg/kg mixed in 250 mL of 5% dextrose infused in 20 min, followed by an infusion of 150 mg/kg in 250 mL of 5% dextrose over 24 h) or placebo. The infusion was started after the induction of anesthesia. ⋯ However, the changes in the NAG/creatinine ratio and the albumin/creatinine ratio were not significantly different between the two groups. Plasma creatinine and serum cystatin C values remained unchanged during the study period in both groups. In conclusion, N-acetylcysteine did not offer any significant protection from renal injury during elective aortic operation in patients with normal preoperative renal function, and some degree of tubular injury seems to occur before aortic crossclamp.
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Anesthesia and analgesia · Jun 2006
Controlled Clinical TrialThe effects of age on the median effective concentration of ropivacaine for motor blockade after epidural anesthesia with ropivacaine.
Minimal local analgesic concentrations have been defined as the median effective concentration (EC50). In this study, we sought to examine the effect of age on motor blockade and determine the motor block EC50 of elderly patients after epidural administration of ropivacaine in patients undergoing urological or minor lower limb surgery. ASA physical status I-II patients were enrolled in 1 of 2 age groups (Group 1: > or =70 yr; Group 2: <70 yr). ⋯ Effective motor blockade was defined as a modified Bromage score >0 within 30 min. The motor blockade EC50 of ropivacaine was 0.383% (95% confidence interval, 0.358%-0. 409%) in group 1 and 0.536% (95% confidence interval, 0.512%-0.556%) in group 2 (P < 0.01). We conclude that age is a determinant of motor blockade EC50 of ropivacaine with epidural administration.