Anesthesia and analgesia
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Anesthesia and analgesia · Apr 2010
Review Meta AnalysisCombining paracetamol (acetaminophen) with nonsteroidal antiinflammatory drugs: a qualitative systematic review of analgesic efficacy for acute postoperative pain.
There has been a trend over recent years for combining a nonsteroidal antiinflammatory drug (NSAID) with paracetamol (acetaminophen) for pain management. However, therapeutic superiority of the combination of paracetamol and an NSAID over either drug alone remains controversial. We evaluated the efficacy of the combination of paracetamol and an NSAID versus either drug alone in various acute pain models. ⋯ Current evidence suggests that a combination of paracetamol and an NSAID may offer superior analgesia compared with either drug alone.
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Anesthesia and analgesia · Apr 2010
Monitoring with head-mounted displays in general anesthesia: a clinical evaluation in the operating room.
Patient monitors in the operating room are often positioned where it is difficult for the anesthesiologist to see them when performing procedures. Head-mounted displays (HMDs) can help anesthesiologists by superimposing a display of the patient's vital signs over the anesthesiologist's field of view. Simulator studies indicate that by using an HMD, anesthesiologists can spend more time looking at the patient and less at the monitors. We performed a clinical evaluation testing whether this finding would apply in practice. ⋯ An HMD of patient vital signs reduces anesthesiologists' surveillance of the anesthesia workstation and allows them to spend more time monitoring their patient and surgical field during normal anesthesia. More research is needed to determine whether the behavioral changes can lead to improved anesthesiologist performance in the operating room.
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Anesthesia and analgesia · Apr 2010
Randomized Controlled Trial Comparative StudyA prospective, randomized, double-blind comparison of ultrasound-guided axillary brachial plexus blocks using 2 versus 4 injections.
In this prospective, randomized, double-blind study, we compared the effectiveness and time efficiency of perioperative axillary blocks performed via 2 different techniques, 1 involving 2 and the other 4 separate skin punctures. ⋯ An ultrasound-guided 2-injection axillary block may be as effective as, and more time efficient than, a 4-injection technique.
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Anesthesia and analgesia · Apr 2010
Derivation and validation of a simple perioperative sleep apnea prediction score.
Obstructive sleep apnea (OSA) is a largely underdiagnosed, common condition, which is important to diagnose preoperatively because it has implications for perioperative management. Our purpose in this study was to identify independent clinical predictors of a diagnosis of OSA in a general surgical population, develop a perioperative sleep apnea prediction (P-SAP) score based on these variables, and validate the P-SAP score against standard overnight polysomnography. ⋯ The P-SAP score predicts diagnosis of OSA with dependable accuracy across mild to severe disease. The elements of the P-SAP score are derived from a typical university hospital surgical population.