Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2008
ReviewAcupuncture for the management of chronic headache: a systematic review.
The objective of this review was to evaluate the efficacy of acupuncture for treatment of chronic headache. ⋯ Needling acupuncture is superior to sham acupuncture and medication therapy in improving headache intensity, frequency, and response rate.
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Anesthesia and analgesia · Dec 2008
Randomized Controlled Trial Comparative StudyA comparison of dexmedetomidine-midazolam with propofol for maintenance of anesthesia in children undergoing magnetic resonance imaging.
Dexmedetomidine is an alpha(2) agonist that is currently being investigated for its suitability to provide anesthesia for children. We compared the pharmacodynamic responses to dexmedetomidine-midazolam and propofol in children anesthetized with sevoflurane undergoing magnetic resonance imaging (MRI). ⋯ Dexmedetomidine-midazolam provides adequate anesthesia for MRI although recovery is prolonged when compared with propofol. Heart rate was slower and systolic blood pressure was greater with dexmedetomidine when compared with propofol. Respiratory indices were similar for the two treatments.
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Anesthesia and analgesia · Dec 2008
Randomized Controlled TrialThe transversus abdominis plane block provides effective postoperative analgesia in patients undergoing total abdominal hysterectomy.
Patients undergoing total abdominal hysterectomy suffer significant postoperative pain. The transversus abdominis plane (TAP) block is a recently described approach to providing analgesia to the anterior abdominal wall. We evaluated the analgesic efficacy of the TAP block in patients undergoing total abdominal hysterectomy via a transverse lower abdominal wall incision, in a randomized, controlled, double-blind clinical trial. ⋯ The TAP block, as a component of a multimodal analgesic regimen, provided superior analgesia when compared to placebo block up to 48 postoperative hours after elective total abdominal hysterectomy.
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Anesthesia and analgesia · Dec 2008
Randomized Controlled TrialThe analgesic efficacy and safety of a novel intranasal morphine formulation (morphine plus chitosan), immediate release oral morphine, intravenous morphine, and placebo in a postsurgical dental pain model.
Opioids are standard treatment for postoperative pain. In this study, we compared the safety and efficacy of intranasal (i.n.) morphine to i.v. and oral morphine and placebo. ⋯ I.n. morphine offers a noninvasive alternative to i.v. morphine for postoperative analgesia.
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Anesthesia and analgesia · Dec 2008
Randomized Controlled TrialLaryngoscopy and tracheal intubation in the head-elevated position in obese patients: a randomized, controlled, equivalence trial.
The proper positioning of patients before direct laryngoscopy is a key step that facilitates tracheal intubation. In obese patients, the 25 degree back-up or head-elevated laryngoscopic position, which is better than the supine position for tracheal intubation, is usually achieved by placing blankets or other devices under the patient's head and shoulders. This position can also be achieved by reconfiguring the normally flat operating room (OR) table by flexing the table at the trunk-thigh hinge and raising the back (trunk) portion of the table (OR table ramp). This table-ramp method can be used without the added expense of positioning devices, and it reduces the possibility of injury to the patient or providers that can occur during removal of such devices once tracheal intubation is achieved. In this study, we sought to determine if the table-ramp method of patient positioning was equivalent to the blanket method with regard to the time required for tracheal intubation. ⋯ Before induction of anesthesia, obese patients can be positioned with their head elevated above their shoulders on the operating table, on a ramp created by placing blankets under their upper body or by reconfiguring the OR table. For the purpose of direct laryngoscopy and tracheal intubation, these two methods are equivalent.