Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2008
Elastomeric pump reliability in postoperative regional anesthesia: a survey of 430 consecutive devices.
Postoperative analgesia via continuous perineural infusion of local anesthetics compares favorably with systemic analgesia. Elastomeric pumps increase patient satisfaction compared with electronic models. In in vitro investigations, infusions remained within 15% of their designated set rates. We assessed in vivo the infusion rate of elastomeric pumps in regional analgesia after orthopedic surgery. ⋯ In vivo reliability of elastomeric pumps is different than in vitro. In the event of early insufficient postoperative perineural analgesia, an absence of deflation of the elastomeric pump must be considered. We recommend weighing these devices every 3 h during the first 24 h of infusion.
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Anesthesia and analgesia · Dec 2008
Randomized Controlled TrialProphylactic dexamethasone decreases the incidence of sore throat and hoarseness after tracheal extubation with a double-lumen endobronchial tube.
Postoperative sore throat and hoarseness are common complications after tracheal intubation, particularly after using a double-lumen endobronchial tube (DLT). We conducted a prospective, randomized, double-blind, placebo-controlled study to evaluate the efficacy of dexamethasone for reducing the incidence and severity of postoperative sore throat and hoarseness. ⋯ The prophylactic use of 0.2 mg/kg of dexamethasone significantly decreases the incidence and severity of sore throat and hoarseness 1 h and 24 h after tracheal extubation of a DLT.
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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 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.