Anesthesia and analgesia
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Anesthesia and analgesia · Jun 2007
Randomized Controlled Trial Comparative StudyMultimodal analgesia to prevent propofol-induced pain: pretreatment with remifentanil and lidocaine versus remifentanil or lidocaine alone.
Propofol is well-known for its pain on injection. Premixture with lidocaine or pretreatment with remifentanil reduces injection pain. A multimodal approach might offer additional mitigation of propofol injection pain. ⋯ The combination of two different analgesic modalities, remifentanil and lidocaine completely abolishes moderate and severe pain associated with propofol injection, and significantly reduces the incidence of mild pain when compared with each drug used alone.
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Anesthesia and analgesia · Jun 2007
Randomized Controlled Trial Comparative StudyThe effects of morphine and fentanyl on the inflammatory response to cardiopulmonary bypass in patients undergoing elective coronary artery bypass graft surgery.
Experimental data suggest that morphine has unique antiinflammatory properties. We hypothesized that morphine, when compared with fentanyl, would attenuate the perioperative inflammatory response to cardiopulmonary bypass (CPB) when administered as part of a balanced anesthetic technique. ⋯ Compared with fentanyl, the administration of morphine as part of balanced anesthetic technique suppressed several components the inflammatory response (IL-6, CD 11b, CD 18, postoperative hyperthermia) to cardiac surgery and CPB.
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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
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 Multicenter Study Comparative StudyThe influence of timing of administration on the analgesic efficacy of parecoxib in orthopedic surgery.
Parecoxib, a selective cyclooxygenase-2 inhibitor, may reduce postoperative pain without increasing bleeding when administered before surgery. ⋯ Administration of parecoxib before hip arthroplasty did not provide preemptive analgesia. There was a trend towards improved analgesia immediately after surgery with preincision administration, consistent with the expected time course of nonsteroidal antiinflammatory drug's effect. Perioperative parecoxib administration, consisting of two injections spaced 12 h apart, improved postoperative analgesia over the first 24 h without increasing bleeding.