Anesthesia and analgesia
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Anesthesia and analgesia · Mar 2010
Randomized Controlled TrialWhat does local tenderness say about the origin of pain? An investigation of cervical zygapophysial joint pain.
Mechanical pain sensitivity is assessed in every patient with pain, either by palpation or by quantitative pressure algometry. Despite widespread use, no studies have formally addressed the usefulness of this practice for the identification of the source of pain. We tested the hypothesis that assessing mechanical pain sensitivity distinguishes damaged from healthy cervical zygapophysial (facet) joints. ⋯ Assessing mechanical pain sensitivity is not diagnostic for cervical zygapophysial joint pain. The finding should stimulate further research into a diagnostic tool that is widely used in the clinical examination of patients with pain.
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Anesthesia and analgesia · Mar 2010
Multicenter StudyWhen blood is not an option: factors affecting survival after the use of a hemoglobin-based oxygen carrier in 54 patients with life-threatening anemia.
In consenting Jehovah's Witness patients and others for whom blood is contraindicated or not available, hemoglobin-based oxygen carrier (HBOC)-201 may enable survival in acutely anemic patients while underlying conditions are treated. ⋯ Earlier, compared with later, administration by inexperienced users of HBOC-201 to patients with anemia was associated with improved chances of survival of acutely bleeding and hemolyzing patients. Survival was more likely if the duration and magnitude of low hemoglobin was minimized before treatment with HBOC-201.
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Anesthesia and analgesia · Mar 2010
An anatomical basis for blocking of the deep cervical plexus and cervical sympathetic tract using an ultrasound-guided technique.
A selective blocking method for the cervical plexus and the cervical sympathetic trunk has not yet been established. ⋯ The longus capitis muscle is a suitable landmark for blocking the cervical plexus and trunk.
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Anesthesia and analgesia · Mar 2010
Chloral hydrate sedation in term and preterm infants: an analysis of efficacy and complications.
Term and preterm infants are at risk of developing apnea after receiving general anesthesia. The risk of apnea after sedation with chloral hydrate (CH) in this population is unknown. In this study, we aimed to describe the clinical course of infants younger than 1 year who received CH for magnetic resonance imaging (MRI), with regard to the efficacy of CH sedation, the need for additional sedative drugs, and the incidence of oxyhemoglobin desaturation or need for oxygen supplementation. We aimed to determine the relationship between these factors to chronological age in term infants and gestational and postconceptional age (PCA) in preterm infants (<37 weeks' gestation). ⋯ The occurrence of postprocedural oxyhemoglobin desaturation was directly correlated with younger chronological age in term infants and younger PCA in preterm infants. Term infants who required extended oxygen supplementation were inpatients and had significant comorbidities.
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Anesthesia and analgesia · Mar 2010
Randomized Controlled TrialA beat-by-beat cardiovascular index, CARDEAN: a prospective randomized assessment of its utility for the reduction of movement during colonoscopy.
We sought to determine whether online use of a beat-by-beat cardiovascular index, CARDEAN (Alpha-2, Lyon, France), modifies the incidence of patient movement during colonoscopy under anesthesia. ⋯ With BIS <60, CARDEAN-guided opioid administration is associated with a reduction of 51% of clinically unpredictable movements in unparalyzed patients undergoing colonoscopy. More studies are required to refine the role of CARDEAN in surgical settings.