Anesthesia and analgesia
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Anesthesia and analgesia · Jun 2007
Comparative StudyThe impact of postoperative discontinuation or continuation of chronic statin therapy on cardiac outcome after major vascular surgery.
Statins reduce cardiac morbidity in nonsurgical populations, and may benefit surgical patients. We sought to examine cardiac outcome in patients who continued, compared with those who discontinued, statin therapy after major vascular surgery. ⋯ Discontinuation of statin therapy after major vascular surgery is associated with an increased postoperative cardiac risk, suggesting that statin therapy should be resumed early after major vascular surgery.
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Anesthesia and analgesia · Jun 2007
Randomized Controlled Trial Comparative StudyAn evaluation of a single dose of magnesium to supplement analgesia after ambulatory surgery: randomized controlled trial.
Previous studies have suggested that magnesium may be a useful adjuvant to postoperative analgesia. ⋯ In patients undergoing ambulatory ilioinguinal hernia repair or varicose vein operations under general anesthesia supplemented with other analgesic adjuvants, pretreatment with IV magnesium sulfate 4 g has no impact on postoperative pain and analgesic consumption.
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Anesthesia and analgesia · Jun 2007
Randomized Controlled Trial Comparative StudyA comparison of single-dose caudal clonidine, morphine, or hydromorphone combined with ropivacaine in pediatric patients undergoing ureteral reimplantation.
Caudal blockade is a common technique for pediatric postoperative analgesia. While safe and effective, caudal opioids are associated with troublesome side effects. Caudal clonidine may offer significant analgesic benefits. We prospectively compared the analgesic, side effect, and rehabilitation profiles of caudal clonidine, hydromorphone, or morphine in a group of 60 pediatric patients undergoing ureteral reimplantation. ⋯ Although caudal morphine may result in more sustained initial analgesia, caudal clonidine combined with nurse-controlled analgesia appears to provide comparable analgesia with fewer side effects. Based on these results, the use of caudal clonidine may be superior to caudal opioids after pediatric ureteral reimplantation.
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Anesthesia and analgesia · Jun 2007
ReviewThe role of the anesthesiologist in fast-track surgery: from multimodal analgesia to perioperative medical care.
Improving perioperative efficiency and throughput has become increasingly important in the modern practice of anesthesiology. Fast-track surgery represents a multidisciplinary approach to improving perioperative efficiency by facilitating recovery after both minor (i.e., outpatient) and major (inpatient) surgery procedures. In this article we focus on the expanding role of the anesthesiologist in fast-track surgery. ⋯ The decisions of the anesthesiologist as a key perioperative physician are of critical importance to the surgical care team in developing a successful fast-track surgery program.