Anesthesia and analgesia
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Anesthesia and analgesia · Jan 2008
Randomized Controlled TrialPropofol causes less postoperative pharyngeal morbidity than thiopental after the use of a laryngeal mask airway.
The insertion of a laryngeal mask airway (LMA) may result in postoperative sore throat. The choice of induction drug on airway morbidity after LMA insertion may be important. We performed this study to compare the incidence of postoperative pharyngeal morbidity after the insertion of a LMA in 340 patients administered either 2 mg/kg propofol (group P) or thiopental 5 mg/kg (group T) for induction of anesthesia. ⋯ At 2 h postoperatively, the incidence of sore throat, dysphagia, and postoperative nausea and vomiting in group T was higher than in group P (24% vs 13% for sore throat, 15% vs 3% for dysphagia, 20% vs 11% for nausea, 14% vs 6% for vomiting, P < 0.05). The number-needed-to-treat to prevent sore throat and dysphagia was 10 and 8, respectively (95% confidence intervals, 5-43). We concluded that, when propofol, rather than thiopental, is used for the induction of anesthesia, it results in a lower incidence of early pharyngeal morbidity and postoperative nausea and vomiting after the insertion of a LMA.
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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 TrialPremedication with mirtazapine reduces preoperative anxiety and postoperative nausea and vomiting.
Mirtazapine is a new antidepressant that blocks 5-HT2 and 5-HT3 receptors. With this receptor profile, it is possible that mirtazapine could provide both anxiolysis and efficacy for postoperative nausea and vomiting (PONV). We therefore tested the hypothesis that premedication with mirtazapine can reduce preoperative anxiety and PONV. ⋯ Premedication with mirtazapine 30 mg reduces the level of preoperative anxiety and the risk of PONV in moderate and high-risk female patients.
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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.
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Anesthesia and analgesia · Jan 2008
Randomized Controlled Trial Comparative StudyCan remifentanil replace nitrous oxide during anesthesia for ambulatory orthopedic surgery with desflurane and fentanyl?
The administration of nitrous oxide (N2O) may be associated with side effects and toxicities. Remifentanil shares characteristics with N2O, including MAC-reducing and antinociceptive effects and a rapid decrease in clinical effect when discontinued. We compared the outcome after ambulatory orthopedic surgery with desflurane and fentanyl supplemented with clinically equivalent doses of either N2O or remifentanil. ⋯ This study demonstrates that a remifentanil infusion of 0.085 microg x kg(-1) x min(-1) may be substituted for 66% N2O during desflurane/fentanyl anesthesia without any clinically significant change in outcome.