Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2009
Randomized Controlled TrialThe effect of single-dose propofol injection on pain and quality of life in chronic daily headache: a randomized, double-blind, controlled trial.
On the basis of a small number of case studies, IV propofol has been advocated for the treatment of chronic daily headache (CDH). There has been no randomized controlled trial of this therapy. Our objective in this randomized, double-blind, placebo-controlled trial was to determine whether a single IV dose of propofol 2.4 mg/kg results in clinically significant reduction in disability or pain in CDH for the next 30 days. ⋯ A single IV infusion of propofol 2.4 mg/kg produces a statistically significant, but not clinically meaningful, reduction in disability from CDH 30 days after infusion and does not reduce pain intensity or analgesic use. This study does not support this regimen of IV propofol for clinical management of CDH.
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Anesthesia and analgesia · Dec 2009
Randomized Controlled Trial Multicenter Study Comparative StudyThe Flex-It stylet is less effective than a malleable stylet for orotracheal intubation using the GlideScope.
The GlideScope videolaryngoscope (Verathon Medical, Bothell, WA) usually provides excellent glottic visualization, but directing an endotracheal tube through the vocal cords can be challenging. The goal of the study was to compare the dedicated Flex-It stylet (FIS, Parker Medical, Highlands Ranch, CO) with a malleable stylet, as assessed by time to intubation (TTI). ⋯ In a group of experienced operators using the GlideScope, the FIS was less effective for orotracheal intubation than a malleable endotracheal tube stylet.
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Anesthesia and analgesia · Dec 2009
The role of 20-hydroxyeicosatetraenoic acid in cerebral arteriolar constriction and the inhibitory effect of propofol.
We conducted this study to examine, in cerebral parenchymal arterioles, whether 20-hydroxyeicosatetraenoic acid (20-HETE) induces constrictor responses via superoxide and whether propofol reduces this constriction. ⋯ Either neuronal transmission-dependent or exogenous 20-HETE seems to induce cerebral parenchymal arteriolar constriction via superoxide production resulting from NADPH oxidase activation. Propofol is likely to prevent this constriction via inhibition of NADPH oxidase, but not by its scavenging effect on superoxide.
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Anesthesia and analgesia · Dec 2009
Improvement in psychosocial outcomes in chronic pain patients receiving intrathecal morphine infusions.
When conventional multimodal analgesic therapy is unsuccessful, more aggressive analgesic treatments are required for patients with intractable chronic pain. Despite extensive clinical experience with implanted morphine pumps, there is still controversy regarding the psychosocial effects of this invasive analgesic therapy. In this prospective study, we evaluated the impact of intrathecal (IT) morphine infusions on pain perception and psychosocial functionality. A secondary objective of this pilot study was to assess the effect of IT morphine infusion on the patient's level of functional activity. ⋯ IT infusion of morphine using an implantable pump was helpful in improving psychosocial function in patients with intractable pain that had failed to respond to standard multimodal analgesic therapy.
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Anesthesia and analgesia · Dec 2009
The efficacy and safety of continuous intravenous administration of remifentanil for birth pain relief: an open study of 205 parturients.
In an observational study, we prospectively evaluated the efficacy and safety of remifentanil in 205 parturients. Remifentanil was administered as a continuous infusion. ⋯ The mean (+/-sd) visual analog score before the start of the infusion was 9.4 +/- 1.2 cm and decreased to 5.1 +/- 0.4 cm after 5 min and 3.6 +/- 1.5 cm after 30 min. The maternal side effects were minimal and no fetal or neonatal side effects were noted.