Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2012
Randomized Controlled TrialA single preoperative dose of gabapentin does not improve postcesarean delivery pain management: a randomized, double-blind, placebo-controlled dose-finding trial.
A single preoperative dose of 600 mg gabapentin, combined with multimodal analgesia, has previously been shown to reduce postcesarean pain and improve maternal satisfaction but was associated with increased maternal sedation. We hypothesized that a lower dose of gabapentin may be effective with less sedation. ⋯ Given the wide confidence intervals of the differences in mean pain scores, the current study did not allow us to determine whether a single preoperative dose of gabapentin (300 mg and 600 mg) improved postcesarean analgesia compared to placebo in the context of a multimodal analgesic regimen. A larger study is required.
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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
ReviewReview article: update in trauma anesthesiology: perioperative resuscitation management.
The management of trauma patients has matured significantly since a systematic approach to trauma care was introduced nearly a half century ago. The resuscitation continuum emphasizes the effect that initial therapy has on the outcome of the trauma patient. The initiation of this continuum begins with prompt field medical care and efficient transportation to designated trauma centers, where lifesaving procedures are immediately undertaken. ⋯ The concept of "early goal-directed therapy" used in sepsis may be applicable in trauma as well. An early, appropriately aggressive resuscitation with blood products, as well as adjunctive pharmacologic therapy, may attenuate the systemic inflammatory response of trauma. Future investigations will need to determine whether this approach offers a similar survival benefit.
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Anesthesia and analgesia · Dec 2012
Case ReportsCase report: an unforeseen peril of parental presence during induction of anesthesia.
Parental presence during induction of anesthesia is a common practice to allay perioperative anxiety in the pediatric population. We present the first documented case in the anesthesia literature of parental interruption of induction of anesthesia. The report is to inform practitioners of the need for perioperative screening, education, and contingency planning to prepare for the possibility of familial disruption during pediatric inductions, cesarean deliveries, and other practice settings that may have lay people present.