Anesthesia and analgesia
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Anesthesia and analgesia · Aug 2009
Randomized Controlled TrialHealth-related quality of life after hip arthroplasty with and without an extended-duration continuous posterior lumbar plexus nerve block: a prospective, 1-year follow-up of a randomized, triple-masked, placebo-controlled study.
We previously reported that extending an overnight continuous posterior lumbar plexus nerve block to 4 days after hip arthroplasty provides clear benefits during the perineural infusion in the immediate postoperative period. However, it remains unknown whether the extended infusion improves subsequent health-related quality of life. ⋯ This investigation found no evidence that extending an overnight continuous posterior lumbar plexus nerve block to 4 days improves (or worsens) subsequent health-related quality of life between 7 days and 12 mo after hip arthroplasty.
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Anesthesia and analgesia · Aug 2009
Randomized Controlled Trial Comparative StudyA randomized trial of the traditional sitting position versus the hamstring stretch position for labor epidural needle placement.
Anecdotal and experimental evidence suggest that a sitting position with maximum knee extension, hip adduction, and forward lean (hamstring stretch position) may produce better reversal of the lumbar lordosis than a traditional sitting position. ⋯ The hamstring stretch position is equivalent to the traditional sitting position in terms of the number of needle-bone contacts encountered when placing labor epidural needles.
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Anesthesia and analgesia · Aug 2009
Tracking hypotension and dynamic changes in arterial blood pressure with brachial cuff measurements.
Arterial cannulation is strongly recommended during shock. Nevertheless, this procedure is associated with significant risks and may delay other emergent procedures. We assessed the discriminative power of brachial cuff oscillometric noninvasive blood pressure (NIBP) for identifying patients with an invasive mean arterial blood pressure (MAP) below 65 mm Hg or increasing their invasive MAP after cardiovascular interventions. ⋯ NIBP measurements have a good discriminative power for identifying hypotensive patients and performed even better in tracking MAP changes, provided that one averages four NIBP measurements.
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Anesthesia and analgesia · Aug 2009
Case ReportsAutotriggering during pressure support ventilation due to cardiogenic oscillations.
Newer generation anesthesia machines are equipped with a pressure support mode of ventilation, which can be used to support spontaneous ventilation in anesthetized patients. The Drager Apollo anesthesia machine uses an inspiratory limb hot-wire flow sensor to measure inspiratory flow rates. ⋯ In the case we are presenting, cardiac oscillations produced inspiratory flow rates that exceeded the flow trigger and autotriggered pressure support breaths. Autotriggering could be suppressed by increasing the trigger threshold or the positive end-expiratory pressure setting.
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Anesthesia and analgesia · Aug 2009
The antinociceptive effects of intravenous dexmedetomidine in colorectal distension-induced visceral pain in rats: the role of opioid receptors.
In comparison with cutaneous pain, the role of alpha(2)-adrenoceptor (alpha(2)-AR) agonists in visceral pain has not been extensively examined. We aimed to characterize the antinociceptive effect of IV dexmedetomidine on visceral pain in rats and to determine whether antinociception thus produced is mediated by opioid receptors. ⋯ Our data indicate that IV dexmedetomidine exerts pronounced antinociception against CRD-induced visceral pain and suggest that the antinociceptive effect of dexmedotimidine is mediated in part by opioid receptors, but peripheral alpha(2)-ARs are not involved.