Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2010
Randomized Controlled Trial Comparative StudyContinuous interscalene analgesia with ropivacaine 0.2% versus ropivacaine 0.3% after open rotator cuff repair: the effects on postoperative analgesia and motor function.
Interscalene analgesia is a recognized technique for the management of postoperative pain after major shoulder surgery. The most effective local anesthetic concentration in this setting is still controversial. In this study, we compared the analgesia and side effects of a continuous infusion of ropivacaine 0.2% and 0.3% administered through an interscalene catheter for the first 48 hours after surgery. ⋯ The use of ropivacaine 0.3% through an interscalene catheter for the first 48 hours after open rotator cuff repair provided a significant reduction of morphine consumption and a better sleep quality for the first postoperative night without increasing the intensity of motor block or side effects.
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Anesthesia and analgesia · Dec 2010
ReviewA program for computing the prediction probability and the related receiver operating characteristic graph.
Prediction probability (P(K)) and the area under the receiver operating characteristic curve (AUC) are statistical measures to assess the performance of anesthetic depth indicators, to more precisely quantify the correlation between observed anesthetic depth and corresponding values of a monitor or indicator. In contrast to many other statistical tests, they offer several advantages. First, P(K) and AUC are independent from scale units and assumptions on underlying distributions. ⋯ In clinical investigations, both measures are applied for indicator assessment, where ambiguous usage and interpretation may be a consequence. Therefore, a summary of the concepts of P(K) and AUC including brief and easily understandable proof of their equality is presented in the text. The exposure introduces readers to the algorithms of the provided computer program and is intended to make standardized performance tests of depth of anesthesia indicators available to medical researchers.
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Anesthesia and analgesia · Dec 2010
ReviewWhat's new in obstetric anesthesia in 2009? An update on maternal patient safety.
Every year, the Society of Obstetric Anesthesia and Perinatology nominates 1 individual to survey the prior year's literature and to identify the most notable articles for the science and practice of obstetric anesthesiology. This article reviews the 2009 literature, focusing on the theme of maternal patient safety, and advancing the notion of the obstetric anesthesiologist as both a perioperative and a peripartum physician. Three specific topics are reviewed: complications of obstetric anesthesia, general obstetric complications, and quality and safety in peripartum care.
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Anesthesia and analgesia · Dec 2010
The association between lower extremity continuous peripheral nerve blocks and patient falls after knee and hip arthroplasty.
Continuous peripheral nerve blocks (CPNB) may induce muscle weakness, and multiple recently published series emphasize patient falls after postarthroplasty CPNB. However, none have included an adequate control group, and therefore the relationship between CPNB and falls remains speculative. ⋯ Our analysis suggests that there is a causal relationship between CPNB and the risk of falling after knee and hip arthroplasty.
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Anesthesia and analgesia · Dec 2010
Randomized Controlled TrialDexmedetomidine added to levobupivacaine prolongs axillary brachial plexus block.
We evaluated the effect of adding dexmedetomidine to levobupivacaine for axillary brachial plexus blockade. The primary endpoints were the onset and duration of sensory and motor block and duration of analgesia. ⋯ Dexmedetomidine added to levobupivacaine for axillary brachial plexus block shortens the onset time and prolongs the duration of the block and the duration of postoperative analgesia. However, dexmedetomidine also may lead to bradycardia.