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 StudyA randomized, dose-response study of sugammadex given for the reversal of deep rocuronium- or vecuronium-induced neuromuscular blockade under sevoflurane anesthesia.
Sugammadex is the first of a new class of selective muscle relaxant binding drugs developed for the rapid and complete reversal of neuromuscular blockade induced by rocuronium and vecuronium. Many studies have demonstrated a dose-response relationship with sugammadex for reversal of neuromuscular blockade in patients induced and maintained under propofol anesthesia. However, sevoflurane anesthesia, unlike propofol, can prolong the effect of neuromuscular blocking drugs (NMBDs) such as rocuronium and vecuronium. ⋯ Sugammadex at doses of > or = 4 mg/kg provides rapid reversal of deep rocuronium- and vecuronium-induced neuromuscular blockade under sevoflurane maintenance anesthesia.
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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 TrialHemispheric synchronized sounds and perioperative analgesic requirements.
Data on the effect of Hemisync sounds on perioperative analgesic requirements are scant. ⋯ The use of Hemisync sounds before and during general anesthesia reduces intraoperative analgesic requirements, postoperative pain scores, and discharge time.
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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.