Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2008
Randomized Controlled TrialThe safety and analgesic efficacy of intranasal ketorolac in patients with postoperative pain.
We evaluated the safety and efficacy of multiple doses of intranasal ketorolac tromethamine (ketorolac) for postoperative pain. ⋯ Thirty milligrams of intranasal ketorolac demonstrated significant analgesic efficacy compared to 10 mg of intranasal ketorolac and placebo.
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Anesthesia and analgesia · Dec 2008
Randomized Controlled TrialRecovery profiles from dexmedetomidine as a general anesthetic adjuvant in patients undergoing lower abdominal surgery.
Dexmedetomidine induces less change in hemodynamic values during the extubation period. This drug may be useful in anesthetic management requiring smooth emergence from anesthesia. We sought to determine the effects of co-administration of dexmedetomidine on the recovery profiles from sevoflurane and propofol, which usually provide safe and rapid recovery when administered alone. ⋯ When co-administered with dexmedetomidine, sevoflurane produced a shorter time to eye opening than propofol. Postoperative cognitive function was not affected by dexmedetomidine administration. These results suggest dexmedetomidine may delay recovery when given as an adjuvant to propofol during total i.v. anesthesia.
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Anesthesia and analgesia · Dec 2008
Randomized Controlled TrialA randomized controlled trial of three patient-controlled epidural analgesia regimens for labor.
Patient-controlled epidural analgesia (PCEA) is a safe and effective mode of maintaining labor analgesia; however, the ideal PCEA regimen is controversial. ⋯ Demand-only PCEA (5-mL bolus, 15-min lockout interval) resulted in less local anesthetic consumption but an increased incidence of breakthrough pain, higher pain scores, shorter duration of effective analgesia, and lower maternal satisfaction, when compared with PCEA with background infusion (5-mL bolus, 10-12-min lockout interval, and 5-10 mL/h infusion).
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Anesthesia and analgesia · Dec 2008
Randomized Controlled TrialBupivacaine infusion above or below the fascia for postoperative pain treatment after abdominal hysterectomy.
We evaluated in which anatomic layer (above the fascia [AF] or below the fascia [BF]) wound infusion of bupivacaine has the best effect on postoperative pain after abdominal hysterectomy. ⋯ We conclude that bupivacaine wound infusion AF provides better postoperative analgesia compared with infusion BF in the first 12 h after abdominal hysterectomy.
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Anesthesia and analgesia · Dec 2008
Randomized Controlled TrialKetamine and lornoxicam for preventing a fentanyl-induced increase in postoperative morphine requirement.
N-methyl-D-aspartate receptor antagonists and nonsteroidal anti-inflammatory drugs are believed to prevent opioid-induced hyperalgesia and/or acute opioid tolerance, which could cause an increase in postoperative opioid requirement. In this randomized, double-blind, placebo-controlled study, we investigated whether co-administration of ketamine or lornoxicam and fentanyl could prevent the increase of postoperative morphine requirement induced by fentanyl alone. ⋯ Our data suggest that the increase of postoperative morphine requirements induced by intraoperative administration of fentanyl could be prevented by ketamine or lornoxicam.