Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2007
GuidelineSociety for Ambulatory Anesthesia guidelines for the management of postoperative nausea and vomiting.
The present guidelines were compiled by a multidisciplinary international panel of individuals with interest and expertise in postoperative nausea and vomiting (PONV) under the auspices of The Society of Ambulatory Anesthesia. The panel critically evaluated the current medical literature on PONV to provide an evidence-based reference tool for the management of adults and children who are undergoing surgery and are at increased risk for PONV. In brief, these guidelines identify risk factors for PONV in adults and children; recommend approaches for reducing baseline risks for PONV; identify the most effective antiemetic monotherapy and combination therapy regimens for PONV prophylaxis; recommend approaches for treatment of PONV when it occurs; and provide an algorithm for the management of individuals at increased risk for PONV.
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Anesthesia and analgesia · Dec 2007
Comparative StudyA bibliometric analysis of global clinical research by anesthesia departments.
Few studies have investigated the diversity in research conducted by anesthesia-based researchers. We examined global clinical research attributed to anesthesia departments using Medline and Ovid databases. We also investigated the impact of economic development on national academic productivity. ⋯ Clinical research attributable to investigators in our specialty is diverse, and extends beyond the traditional field of anesthesia and intensive care. The United States produces the most clinical research, but per capita output is higher in European nations.
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Anesthesia and analgesia · Dec 2007
Randomized Controlled Trial Comparative StudyA randomized controlled trial of femoral nerve blockade administered preclinically for pain relief in femoral trauma.
Analgesia at the location of the accident and on transport for femoral trauma is often delayed or insufficient. In this prospective, randomized, controlled study, we evaluated the preclinical use of femoral nerve blockade for reducing pain and anxiety compared with IV analgesia using metamizol. ⋯ Preclinically administered femoral nerve blockade effectively decreases pain, anxiety, and heart rate after femoral trauma. Regional blockade is an option for out-of-hospital analgesia administered by a trained physician.
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Anesthesia and analgesia · Dec 2007
Comparative StudyThe analgesic effects of opioids and immersive virtual reality distraction: evidence from subjective and functional brain imaging assessments.
Immersive virtual reality (VR) is a novel form of distraction analgesia, yet its effects on pain-related brain activity when used adjunctively with opioid analgesics are unknown. We used subjective pain ratings and functional magnetic resonance imaging to measure pain and pain-related brain activity in subjects receiving opioid and/or VR distraction. ⋯ These subjective pain reports and objective functional magnetic resonance imaging results demonstrate converging evidence for the analgesic efficacy of opioid administration alone and VR distraction alone. Furthermore, patterns of pain-related brain activity support the significant subjective analgesic effects of VR distraction when used as an adjunct to opioid analgesia. These results provide preliminary data to support the clinical use of multimodal (e.g., combined pharmacologic and nonpharmacologic) analgesic techniques.
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Anesthesia and analgesia · Dec 2007
Randomized Controlled Trial Comparative StudyThe 8-item Short-Form Health Survey and the physical comfort composite score of the quality of recovery 40-item scale provide the most responsive assessments of pain, physical function, and mental function during the first 4 days after ambulatory knee surgery with regional anesthesia.
We evaluated the validity and responsiveness of three instruments: the numeric rating scale (NRS) pain score, the 8-item Short-Form Health Survey (SF-8), and the 40-item Quality of Recovery from Anesthesia (QoR) Survey in 154 outpatients undergoing anterior cruciate ligament reconstruction (ACLR). The objective was to provide a robust psychometric basis for outcome survey selection for surgical outpatients undergoing regional anesthesia without general anesthesia. ⋯ For ACLR outpatients receiving regional anesthesia, the SF-8 is sufficient to assess postoperative pain and physical function. Adding the QoR physical comfort composite will help assess short-term side effects.