Anesthesia and analgesia
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Anesthesia and analgesia · Aug 2007
Randomized Controlled Trial Comparative StudyLiberal versus restrictive fluid management in knee arthroplasty: a randomized, double-blind study.
There are few data describing the relationship between amount of perioperative fluid and organ function. In this study we investigated the effects of two levels of intravascular fluid administration ("liberal" versus "restrictive") in knee arthroplasty on physiological recovery as the primary outcome variable. ⋯ A liberal compared to a restrictive intravascular fluid regimen may lead to significant hypercoagulability and a reduction in vomiting, but without differences in other recovery variables or hospital stay after fast-track knee arthroplasty.
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Anesthesia and analgesia · Aug 2007
Multicenter Study Comparative StudyFactors predictive of patient satisfaction with anesthesia.
In this multicenter prospective study, we identified factors associated with satisfaction with anesthesia in patients staying in hospital at least 24 h after surgery. ⋯ Inpatient satisfaction can be improved by an organization in which surgical suite nurses are dedicated only to anesthesia, a written anesthesia information leaflet is given during the preoperative visit and postoperative visits are enhanced.
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Anesthesia and analgesia · Aug 2007
Comparative StudyTrendelenburg position, simulated Valsalva maneuver, and liver compression do not alter the size of the right internal jugular vein in patients with a bidirectional Glenn shunt.
Ultrasound is increasingly used to facilitate right internal jugular vein (RIJV) cannulation in children. In children without cardiac disease, position changes and enhancement maneuvers increase RIJV cross-sectional area (CSA) and further facilitate cannulation. We investigated the effect of these maneuvers on RIJV CSA in children with a bidirectional Glenn (BDG) shunt presenting for a Fontan procedure. ⋯ Position changes and enhancement maneuvers are unlikely to facilitate RIJV cannulation in BDG shunt patients presenting for Fontan procedure because these interventions do not increase RIJV CSA.
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Anesthesia and analgesia · Aug 2007
Randomized Controlled Trial Comparative StudyA double-blind, crossover assessment of the sedative and analgesic effects of intranasal dexmedetomidine.
The alpha2-receptor agonist, dexmedetomidine, provides sedation with facilitated arousal and analgesia with no respiratory depression. These properties render it potentially useful for anesthesia premedication, although parenteral administration is not practical in this setting. We designed this study to evaluate the sedative, anxiolytic, analgesic, and hemodynamic effects of dexmedetomidine administered intranasally in healthy volunteers. ⋯ The intranasal route is effective, well tolerated, and convenient for the administration of dexmedetomidine. Future studies are required to evaluate the possible role of the noninvasive route of administration of dexmedetomidine in various clinical settings, including its role as premedication prior to induction of anesthesia.
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Anesthesia and analgesia · Aug 2007
Randomized Controlled Trial Comparative StudyThe prolonged postoperative analgesic effect when dexamethasone is added to a nonsteroidal antiinflammatory drug (rofecoxib) before breast surgery.
Glucocorticoids provide analgesia. In this study, we evaluated the effects of adding dexamethasone to a multimodal postoperative analgesic regimen, including a long-acting nonsteroidal antiinflammatory drug. ⋯ Dexamethasone 16 mg provides prolonged postoperative analgesia from 24 to 72 h after surgery when added to a multimodal regimen including nonsteroidal antiinflammatory drug (rofecoxib).