Anesthesia and analgesia
-
Anesthesia and analgesia · Mar 2010
Randomized Controlled Trial Multicenter StudyPosttraumatic stress disorder in aware patients from the B-aware trial.
The long-term consequences of an awareness episode vary. Some patients do not have any long-term disability, whereas others develop psychological problems that may be severe and persistent. In this study, we compared the incidence of posttraumatic stress disorder (PTSD) in patients with and without confirmed awareness who were randomized in the B-Aware Trial. ⋯ PTSD was common and persistent in the confirmed awareness patients of the B-Aware Trial. Strategies to prevent awareness in patients under general anesthesia are justified.
-
Anesthesia and analgesia · Mar 2010
Randomized Controlled Trial Comparative StudyA comparison of 3% hypertonic saline and mannitol for brain relaxation during elective supratentorial brain tumor surgery.
In this study, we compared the effects of 3% hypertonic saline (HTS) and 20% mannitol on brain relaxation during supratentorial brain tumor surgery, intensive care unit (ICU) stays, and hospital days. ⋯ Our results suggest that HTS provided better brain relaxation than did mannitol during elective supratentorial brain tumor surgery, whereas it did not affect ICU stays or hospital days.
-
Anesthesia and analgesia · Mar 2010
A national survey of American Pediatric Anesthesiologists: patient-controlled analgesia and other intravenous opioid therapies in pediatric acute pain management.
The influence of patient characteristics, institutional demographics, and published practice guidelines on the provision of IV opioid analgesia, particularly as delivered through a patient-controlled analgesia (PCA) delivery device, to pediatric patients is unknown. ⋯ Although IVPCA was available to pediatric patients at most institutions surveyed, prescribing practices and supervision of pediatric pain management were influenced by patient characteristics, institutional demographics, and published national guidelines. Recalled life-threatening events were reported in conjunction with all modes of opioid infusion therapy. Interventions that might diminish the incidence of adverse events but are not used to their fullest extent include improved education and implementation of systems designed to minimize human error involved in the prescribing of opioids. Providing a more accurate accounting of complications would require institutions to participate in a prospective data-collecting consortium designed to track both the incidence of therapy and associated complications.
-
Anesthesia and analgesia · Mar 2010
Randomized Controlled Trial Comparative StudyResistive-polymer versus forced-air warming: comparable efficacy in orthopedic patients.
Several adverse consequences are caused by mild perioperative hypothermia. Maintaining normothermia with patient warming systems, today mostly with forced air (FA), has thus become a standard procedure during anesthesia. Recently, a polymer-based resistive patient warming system was developed. We compared the efficacy of a widely distributed FA system with the resistive-polymer (RP) system in a prospective, randomized clinical study. ⋯ RP warming performed as efficiently as FA warming in patients undergoing orthopedic surgery.
-
Anesthesia and analgesia · Mar 2010
Randomized Controlled Trial Comparative StudyResistive-heating or forced-air warming for the prevention of redistribution hypothermia.
We evaluated the efficacy of resistive-heating or forced-air warming versus no prewarming, applied before induction of anesthesia for prevention of hypothermia. ⋯ Prewarming should be considered part of the anesthetic management when patients are at risk for postoperative hypothermia.