Anesthesia and analgesia
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There is growing interest in the use of regional anesthesia worldwide. With this survey, we determined the use of regional techniques among anesthesiologists in Nigeria using a cross-sectional study design. A self-administered questionnaire was mailed to a randomly generated list of anesthesiologists in Nigeria. ⋯ Regular use of spinal, epidural, and peripheral nerve blocks was 92.9%, 15%, and 2.9%, respectively. A high percentage of respondents (47.1%) had never performed a nerve block and only 31.4% had used a nerve stimulator technique. Limited exposure to equipment and techniques accounted for their lack of use.
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Anesthesia and analgesia · Jan 2010
Randomized Controlled Trial Multicenter Study Comparative StudySugammadex provides faster reversal of vecuronium-induced neuromuscular blockade compared with neostigmine: a multicenter, randomized, controlled trial.
Sugammadex, a specifically designed gamma-cyclodextrin, is a selective relaxant binding drug that rapidly reverses rocuronium-induced and, to a lesser extent, vecuronium-induced neuromuscular blockade. In this study, we compared the efficacy of sugammadex and neostigmine for the reversal of vecuronium-induced neuromuscular blockade in patients scheduled for elective surgery. ⋯ Sugammadex provided significantly faster reversal of vecuronium-induced neuromuscular blockade compared with neostigmine.
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Anesthesia and analgesia · Jan 2010
Randomized Controlled Trial Multicenter StudyMonitored anesthesia care with dexmedetomidine: a prospective, randomized, double-blind, multicenter trial.
Dexmedetomidine (DEX) is increasingly being used as a sedative for monitored anesthesia care (MAC) because of its analgesic properties, "cooperative sedation," and lack of respiratory depression. In this randomized, multicenter, double-blind, Phase III Food and Drug Administration study, we evaluated the safety and efficacy of two doses of DEX for sedation of patients undergoing a broad range of surgical or diagnostic procedures requiring MAC. ⋯ DEX is an effective baseline sedative for patients undergoing MAC for a broad range of surgical procedures providing better patient satisfaction, less opioid requirements, and less respiratory depression than placebo rescued with midazolam and fentanyl.
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Anesthesia and analgesia · Jan 2010
Randomized Controlled TrialA randomized, double-blind, placebo-controlled trial of epidural morphine analgesia after vaginal delivery.
Pain after vaginal delivery can interfere with the activities of daily living. We hypothesized that epidural medication administered after delivery would be of benefit for acute postpartum pain management. The objective of this study was to assess whether epidural morphine after vaginal delivery would reduce the analgesic requirements for perineal pain. ⋯ There was a 78% reduction in analgesic requirements in women given epidural morphine after vaginal delivery compared with placebo for both primiparous and multiparous patients. Women who receive epidural labor analgesia for vaginal deliveries and stay in the hospital for 24 h after delivery may benefit from postpartum administration of epidural morphine.
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Anesthesia and analgesia · Jan 2010
Comparative StudyThe risk-benefit profile of aprotinin versus tranexamic acid in cardiac surgery.
Aprotinin is superior to other antifibrinolytic drugs for preventing major blood loss after cardiac surgery but may also increase perioperative mortality. It remains unclear whether its risk-benefit profile differs among low-, moderate-, and high-risk cardiac surgical patients. ⋯ Aprotinin tends to have a better risk-benefit profile than tranexamic acid in high-risk, but not low- to moderate-risk, patients. Its use in high-risk cases may therefore be warranted.