Anesthesia and analgesia
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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
Development and validation of predictors of respiratory insufficiency and mortality scores: simple bedside additive scores for prediction of ventilation and in-hospital mortality in acute cervical spine injury.
Numerous studies have developed a "severity score" or "risk index" for mechanical ventilation and mortality, but there are few to predict outcomes for cervical spine injury (CSI) patients. Our objective in this study was to develop a simple bedside additive predictive score for requirement for ventilation and early in-hospital mortality for patients with CSI. ⋯ PRIM scores enable accurate prediction of individual patient risk of need for mechanical ventilation and in-hospital mortality in association with acute CSI.
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Anesthesia and analgesia · Jan 2010
Case ReportsSpinal cord stimulation for severe degenerative joint disease of the shoulder in a patient with severe chronic obstructive pulmonary disease: a new indication?
Approximately 70% of the United States population older than 65 yr has osteoarthritis. Chronic obstructive pulmonary disease (COPD) is also more prevalent in the elderly, and thus, the likelihood of having elderly patients with osteoarthritis and COPD in clinical settings is significant. COPD may preclude the optimum use of opioids, thus the potential to provide pain control with nonpharmacological treatment modalities becomes a valuable option. We present the case of an elderly woman with severe degenerative joint disease of the shoulder and severe COPD in whom spinal cord stimulation was used to provide pain control.
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Anesthesia and analgesia · Jan 2010
Biography Historical ArticleElton Romeo Smilie, the not-quite discoverer of ether anesthesia.
Like William T. G. Morton, Elton Romeo Smilie (1819-1889) was raised in Massachusetts, attended medical school in New England, practiced dentistry there, strove for clinical invention, and moved to Boston. ⋯ The two authors collaborated on chloroform, but Smilie soon headed off in the Gold Rush to California. It is tempting to speculate that Charles T. Jackson and Morton were indebted in part to Smilie.