Anesthesia and analgesia
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Anesthesia and analgesia · Oct 2011
Review Meta AnalysisA comparison between remifentanil and meperidine for labor analgesia: a systematic review.
Remifentanil is an ultrashort-acting opioid with favorable pharmacokinetic properties that make it suitable as a labor analgesic. Although it crosses the placenta freely, it is eliminated quickly in the neonate by rapid metabolism and redistribution. We aimed to determine whether remifentanil compared with meperidine is effective in reducing pain scores in laboring parturients. Other effects on the mother, the labor process, and the neonate were also examined. ⋯ Compared with meperidine, remifentanil is superior in reducing mean VAS scores for labor pain after 1 hour.
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Anesthesia and analgesia · Oct 2011
Lidocaine attenuates the development of diabetic-induced tactile allodynia by inhibiting microglial activation.
Lidocaine is used clinically for tactile allodynia associated with diabetes-induced neuropathy. Although the analgesic effect of lidocaine through suppression of microglial activation has been implicated in the development of injury-induced neuropathic pain, its mechanism of action in diabetes-induced tactile allodynia has not yet been completely elucidated. ⋯ Lidocaine alleviates STZ-induced tactile allodynia, possibly by modulating the p38 pathway in spinal microglial cells. Inhibiting microglial activation by lidocaine treatment early in the course of diabetes-induced neuropathy represents a potential therapeutic strategy for tactile allodynia.
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Anesthesia and analgesia · Oct 2011
Randomized Controlled TrialNitrous oxide paradoxically modulates slow electroencephalogram oscillations: implications for anesthesia monitoring.
Anesthesia with nitrous oxide preserves awake features of the EEG leading to inappropriately higher BIS values.
pearl -
Anesthesia and analgesia · Oct 2011
Randomized Controlled Trial Comparative StudyContinuous femoral versus posterior lumbar plexus nerve blocks for analgesia after hip arthroplasty: a randomized, controlled study.
Hip arthroplasty frequently requires potent postoperative analgesia, often provided with an epidural or posterior lumbar plexus local anesthetic infusion. However, American Society of Regional Anesthesia guidelines now recommend against epidural and continuous posterior lumbar plexus blocks during administration of various perioperative anticoagulants often administered after hip arthroplasty. A continuous femoral nerve block is a possible analgesic alternative, but whether it provides comparable analgesia to a continuous posterior lumbar plexus block after hip arthroplasty remains unclear. We therefore tested the hypothesis that differing the catheter insertion site (femoral versus posterior lumbar plexus) after hip arthroplasty has no impact on postoperative analgesia. ⋯ After hip arthroplasty, a continuous femoral nerve block is an acceptable analgesic alternative to a continuous posterior lumbar plexus block when using a stimulating perineural catheter. However, early ambulatory ability suffers with a femoral infusion.