Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2007
Comparative StudyThe effects of centrally administered dexmedetomidine on cardiovascular and sympathetic function in conscious rats.
The alpha2-receptor is expressed in the brain, including the hypothalamus, where it is implicated in autonomic nervous system control. The effects of systemic administration of dexmedetomidine (DEX) on cardiovascular responses are well known; however, little is known about the effects of central administration of DEX on cardiovascular responses in conscious animals. In this study, we explored the effects and the mechanism of intracerebroventricularly (icv) administered DEX on cardiovascular responses and sympathetic nerve activity in conscious, unrestrained rats. ⋯ These results indicate that icv administration of DEX decreases MAP by sympathetic inhibition and decreases HR by sympathetic inhibition and vagal stimulation.
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Anesthesia and analgesia · Dec 2007
Multicenter Study Comparative Study Clinical TrialThe safety and efficacy of extended thromboprophylaxis with fondaparinux after major orthopedic surgery of the lower limb with or without a neuraxial or deep peripheral nerve catheter: the EXPERT Study.
The benefit-risk ratio of extended fondaparinux therapy has not been assessed in patients undergoing major lower limb joint arthroplasty. Few data on the concomitant use of fondaparinux and continuous neuraxial or deep peripheral nerve blockade are available. We performed a prospective intervention study in patients undergoing major orthopedic surgery primarily designed to assess the efficacy of fondaparinux when drug administration was withheld for 48 h to permit removal of a neuraxial or deep peripheral nerve catheter. The safety and efficacy of extended fondaparinux therapy for the prevention of venous thromboembolism were also evaluated. ⋯ Once-daily subcutaneous injection of 2.5 mg fondaparinux given for 3 to 5 wk was effective and safe for prevention of venous thromboembolism after major orthopedic surgery. Temporary discontinuation of fondaparinux for 48 h permitted safe removal of a neuraxial or deep peripheral nerve catheter without decreasing thromboprophylatic efficacy.
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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.
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Anesthesia and analgesia · Dec 2007
Randomized Controlled Trial Comparative StudyThoracic paravertebral block for breast cancer surgery: a randomized double-blind study.
We examined in this randomized, double-blind study whether a multilevel paravertebral block performed before general anesthesia with propofol and a laryngeal mask enhances postoperative analgesia after breast cancer surgery. ⋯ A multilevel paravertebral block provides good analgesia for breast surgery, but the duration of analgesia is briefer than described in previous studies.