Anesthesia and analgesia
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Anesthesia and analgesia · Jan 2008
Randomized Controlled TrialNimesulide 90 mg orally twice daily does not influence postoperative morphine requirements after major chest surgery.
Cyclooxygenase 2 inhibition has proven analgesic efficacy in a variety of surgical procedures. We postulated that perioperative cyclooxygenase 2 inhibition significantly reduces postoperative morphine requirements after major thoracic surgery and investigated the site of this potential analgesic effect. ⋯ Nimesulide, at a dose of 90 mg twice daily in combination with a standard analgesic regimen, does not influence pain scores, morphine requirements, or CSF prostaglandin levels after major thoracic surgery.
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Anesthesia and analgesia · Jan 2008
Randomized Controlled TrialIs the combination of morphine with ketamine better than morphine alone for postoperative intravenous patient-controlled analgesia?
The addition of ketamine to morphine for patient-controlled analgesia (PCA) is supported by previous basic and clinical research, but has been challenged by subsequent negative studies. Important limitations of previous studies are the low number of patients analyzed, the use of morphine-ketamine combinations that may not the optimal, and that not all the relevant outcomes have been analyzed. In this study, we compared the combination of morphine and ketamine with morphine alone for postoperative PCA in large patient groups. We used a morphine-ketamine combination identified by an optimization procedure in our previous study. ⋯ Small-dose ketamine combined with morphine for PCA provides no benefit to patients undergoing major orthopedic surgery and cannot be recommended for routine use.
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Anesthesia and analgesia · Jan 2008
Randomized Controlled TrialA comparison of sedation with dexmedetomidine or propofol during shockwave lithotripsy: a randomized controlled trial.
Dexmedetomidine, because it has both sedative and analgesic properties, may be suitable for conscious sedation during painful procedures. Extracorporeal shockwave lithotripsy (ESWL) is a minimal to mildly painful procedure that requires conscious sedation. We thus evaluated the utility of dexmedetomidine compared with propofol during an ESWL procedure. ⋯ A combination of dexmedetomidine with fentanyl can be used safely and effectively for sedation and analgesia during ESWL.
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Anesthesia and analgesia · Jan 2008
Randomized Controlled TrialThe effect of detailed, video-assisted anesthesia risk education on patient anxiety and the duration of the preanesthetic interview: a randomized controlled trial.
Video-assisted patient education during the preanesthetic clinic visit is a new intervention to increase knowledge transfer to the patient regarding anesthesia procedure and risks. However, little is known about whether video-based patient education influences patient anxiety and the duration of the preanesthetic visit. ⋯ Our study suggests that the use of a video for detailed anesthesia risk education does not change patient anxiety, but leads to a better understanding of the procedure and risks of anesthesia. When the video is shown before the preanesthetic interview, the interview is longer.
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Anesthesia and analgesia · Jan 2008
Clinical TrialThe median effective dose of preemptive gabapentin on postoperative morphine consumption after posterior lumbar spinal fusion.
A single dose of preemptive gabapentin reduces postoperative pain and postoperative analgesic consumption. However, the optimal dose of preemptive gabapentin remains to be evaluated. ⋯ Given the large dose of gabapentin needed, further powered studies are warranted to assess side effects.