Anesthesia and analgesia
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Anesthesia and analgesia · Sep 2007
Randomized Controlled TrialObturator versus femoral nerve block for analgesia after total knee arthroplasty.
Both femoral and obturator nerve blocks have been suggested to be useful in relieving pain after total knee arthroplasty (TKA). We sought to compare their efficacy. ⋯ Femoral nerve blocks rarely block the obturator nerve. Single-injection femoral nerve block improved multimodal analgesia after spinal anesthesia for TKA, but this effect did not persist beyond the day of surgery. Obturator nerve block alone was of no benefit.
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Anesthesia and analgesia · Sep 2007
ReviewPathophysiology of peripheral neuropathic pain: immune cells and molecules.
Damage to the peripheral nervous system often leads to chronic neuropathic pain characterized by spontaneous pain and an exaggerated response to painful and/or innocuous stimuli. This pain condition is extremely debilitating and usually difficult to treat. Although inflammatory and neuropathic pain syndromes are often considered distinct entities, emerging evidence belies this strict dichotomy. ⋯ In addition, these cells release numerous compounds that contribute to pain. Recent evidence suggests that immune cells play a role in neuropathic pain in the periphery. In this review we identify the different immune cell types that contribute to neuropathic pain in the periphery and release factors that are crucial in this particular condition.
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Anesthesia and analgesia · Sep 2007
Comparative StudyMeasurement of anesthetics in blood using a conventional infrared clinical gas analyzer.
Measurement of the partial pressure of volatile anesthetics in blood is usually done using a "headspace equilibration" method with gas chromatography. However, it is not often performed in clinical studies because of the technical, equipment, and logistic requirements. To improve the accessibility of this measurement, we tested the use of a common infrared clinical gas analyzer, the Datex-Ohmeda Capnomac, for this purpose. ⋯ The accuracy and precision of measurement of volatile anesthetic gas partial pressures in blood by a double headspace equilibration technique, using a clinical infrared gas analyzer, were comparable to that achieved by previous studies using gas chromatography.
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Anesthesia and analgesia · Sep 2007
Improving operating room efficiency by applying bin-packing and portfolio techniques to surgical case scheduling.
An operating room (OR) department has adopted an efficient business model and subsequently investigated how efficiency could be further improved. The aim of this study is to show the efficiency improvement of lowering organizational barriers and applying advanced mathematical techniques. ⋯ Efficient OR departments can further improve their efficiency. The paper shows that a radical cultural change that comprises the use of mathematical algorithms and lowering organizational barriers improves OR utilization.
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Anesthesia and analgesia · Sep 2007
Case ReportsEasy endotracheal intubation of a patient suffering from both Cushing's and Nelson's syndromes predicted by the upper lip bite test despite a Mallampati Class 4 airway.
A 31-yr-old woman with concurrent Cushing's and Nelson's syndromes was scheduled for transsphenoidal hypophysectomy. The patient had generalized edema, morbid obesity, and a history of sleep apnea. Her Mallampati assessment was Class 4, suggesting very difficult intubation, but the upper lip bite test predicted easy intubation. After rapid sequence induction, there was a Class 1 view on laryngoscopy, and intubation was accomplished easily.