Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2012
Randomized Controlled Trial Comparative StudyPhenylephrine infusion versus bolus regimens during cesarean delivery under spinal anesthesia: a double-blind randomized clinical trial to assess hemodynamic changes.
This small study (N=60) found no significant clinical difference between bolus phenylephrine and phenylephrine infusion when used to maintain maternal blood pressure during caesarean section conducted under spinal anaesthesia.
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Anesthesia and analgesia · Dec 2012
Randomized Controlled Trial Comparative StudyThe postoperative analgesic efficacy of preperitoneal continuous wound infusion compared to epidural continuous infusion with local anesthetics after colorectal cancer surgery: a randomized controlled multicenter study.
Open colorectal cancer (CRC) surgery induces severe and prolonged postoperative pain. The optimal method of postoperative analgesia in CRC surgery has not been established. We evaluated the efficacy of preperitoneal continuous wound infusion (CWI) of ropivacaine for postoperative analgesia after open CRC surgery in a multicenter randomized controlled trial. ⋯ Preperitoneal CWI analgesia with ropivacaine 0.2% continuous infusion at 10 mL/h during 48 hours after open CRC surgery provided effective postoperative pain relief not inferior to CEI analgesia.
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Anesthesia and analgesia · Dec 2012
Review Historical ArticleSpecial article: mandragora: anesthetic of the ancients.
Initial attempts at surgical anesthesia began many centuries ago, with the plants of antiquity. The mandragora, or mandrake, was used as a sedative and to induce pain relief for surgical procedures. It has been depicted in tablets and friezes since the 16th century before the common era (BCE) and used for its sedative effects by Hannibal (second century BCE) against his enemies. ⋯ The Arabs translated the scientific work of the Ancients and expanded on their knowledge. They developed the Spongia Somnifera, which contained the juice of the mandrake plant. After the fall of the Islamic cities of Europe to the Christians, scientific work was translated into Latin and the Spongia Somnifera was used in Europe until the discovery of the use of ether for surgical anesthesia.
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Anesthesia and analgesia · Dec 2012
Technical communication: anatomy and clinical implications of ultrasound-guided selective femoral nerve block.
In this study we evaluated the anatomic basis and clinical findings of ultrasound-guided femoral nerve block performed close to the distal apex of the femoral triangle. Cadaver studies were conducted in 9 thighs of fresh bodies within 24 hours postmortem. In all cases, during injection of 10 mL of blue dye, the skin proximal to the injection site was compressed to prevent the proximal flow. ⋯ The femoral nerve was successfully dyed in all cases of the cadaver study, whereas the muscular branch to the sartorius muscle and quadriceps muscle, with the exception of the vastus medialis muscle, evaded dyeing. All 20 patients with varus knee deformities reported analgesia; none of them experienced motor block. We conclude that local anesthetic injection at the site where the superficial femoral artery has passed beneath the medial border of the sartorius muscle (8 to 12 cm distal to the inguinal crease), combined with efforts taken to prevent proximal flow may anesthetize the sensation of the anterior-to medial aspect of the knee and motor branch of the vastus medialis muscle, without blocking the sartorius or quadriceps muscles.
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Anesthesia and analgesia · Dec 2012
Randomized Controlled TrialReduction in intraoperative bacterial contamination of peripheral intravenous tubing through the use of a passive catheter care system.
Bacterial contamination of intravascular devices has been associated with increased morbidity and mortality in various hospital settings, including the perioperative environment. Catheter hub disinfection has been shown in an ex vivo model to attenuate intraoperative injection of bacterial organisms originating from the anesthesia provider's hands, providing the impetus for improvement in intraoperative disinfection techniques and compliance. In the current study, we investigated the clinical effectiveness of a new, passive catheter care station in reducing the incidence of bacterial contamination of open lumen patient IV stopcock sets. The secondary aim was to evaluate the impact of this novel intervention on the combined incidence of 30-day postoperative infections and IV catheter-associated phlebitis. ⋯ Intraoperative use of a passive catheter care station significantly reduced open lumen bacterial contamination and the combined incidence of 30-day postoperative infections and phlebitis.