Anesthesia and analgesia
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Anesthesia and analgesia · May 2010
Meta AnalysisMeta-analysis of average and variability of time to extubation comparing isoflurane with desflurane or isoflurane with sevoflurane.
We recently determined how to use anesthesia information management system data to model the time from end of surgery to extubation. We applied that knowledge for meta-analyses of trials comparing extubation times after maintenance with desflurane and sevoflurane. In this study, we repeated the meta-analyses to compare isoflurane with desflurane and sevoflurane. ⋯ The pharmacoeconomics of volatile anesthetics are highly sensitive to measurement of relatively small time differences. Therefore, surgical facilities should use these values combined with their local data (e.g., mean baseline extubation times) when making evidence-based management decisions regarding pharmaceutical purchases and usage guidelines.
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Anesthesia and analgesia · May 2010
Randomized Controlled TrialBilateral acupuncture analgesia observed by quantitative sensory testing in healthy volunteers.
There is evidence that acupuncture activates different spinal and supraspinal antinociceptive systems, but the specific modulatory effects on the sensory system have not been systematically investigated. In this study, we evaluated the immediate effects of different types of acupuncture on thermal, mechanical, and vibratory sensory thresholds. ⋯ There were congruent changes on QST after 3 common acupuncture stimulation methods, with possible unilateral as well as bilateral effects.
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Anesthesia and analgesia · May 2010
Clinical TrialAn evaluation of diaphragmatic movement by M-mode sonography as a predictor of pulmonary dysfunction after upper abdominal surgery.
Diaphragmatic dysfunction is a major factor in the etiology of postoperative pulmonary complications after upper abdominal surgery. M-mode ultrasonography is now an accepted qualitative method of assessing diaphragmatic motion in normal and pathological conditions. In this study, we evaluated whether diaphragmatic inspiratory amplitude (DIA) as measured by M-mode sonography can be a predictor of pulmonary dysfunction. ⋯ DIA using M-mode sonography showed a linear correlation with VC measured by spirometry throughout the postoperative period. We conclude that using the M-mode sonographic technique at the bedside can be a practical way to investigate postoperative diaphragmatic dysfunction, and may also be an effective bedside screening method for diaphragmatic paralysis.
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Anesthesia and analgesia · May 2010
The anatomy of the thoracic spinal canal investigated with magnetic resonance imaging.
We investigated, with magnetic resonance imaging, the distance of the dura mater to the spinal cord in patients without spinal or medullar disease at the 2nd, 5th, and 10th thoracic segments. ⋯ This study demonstrated that there is greater depth of the posterior subarachnoid space at the T2, T5, and T10 levels. The greater distance was found at T5.
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Anesthesia and analgesia · May 2010
Virtual reality imaging with real-time ultrasound guidance for facet joint injection: a proof of concept.
Facet interventions continue to be used in pain management. Computed tomographic (CT) images can be registered into a virtual world that includes images generated by an ultrasound (US) probe tracked in real time, permitting guidance of tracked needles. We acquired CT-generated 3-dimensional (3D) images of 2 models and a cadaver. ⋯ Facet injections were performed in the models and cadaver with radio-opaque markers. A postprocedure CT image determined appropriate placement. The virtual reality system described demonstrates technical innovations that may lead to future advancements in the area of percutaneous interventions in the management of pain.