Anesthesia and analgesia
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Anesthesia and analgesia · Aug 2012
Randomized Controlled TrialSystemic lidocaine to improve postoperative quality of recovery after ambulatory laparoscopic surgery.
Intraoperative intravenous lidocaine improves the quality of recovery following ambulatory laparoscopic surgery.
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Anesthesia and analgesia · Aug 2012
Trends in in-hospital major morbidity and mortality after total joint arthroplasty: United States 1998-2008.
The use of total joint arthroplasties is increasing worldwide. In this work we aim to elucidate recent trends in demographics and perioperative outcomes of patients undergoing total hip (THA) or total knee arthroplasty (TKA). ⋯ Between 1998 and 2008, trends show increases in several major in-hospital complications after THA and TKA, including pulmonary embolism, sepsis, nonmyocardial infarction cardiac complications, and pneumonia. Despite the increase in complications, declining in-hospital mortality was noted over this period.
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Anesthesia and analgesia · Aug 2012
Review Meta AnalysisThe prevention of chronic postsurgical pain using gabapentin and pregabalin: a combined systematic review and meta-analysis.
Many clinical trials have demonstrated the effectiveness of gabapentin and pregabalin administration in the perioperative period as an adjunct to reduce acute postoperative pain. However, very few clinical trials have examined the use of gabapentin and pregabalin for the prevention of chronic postsurgical pain (CPSP). We (1) systematically reviewed the published literature pertaining to the prevention of CPSP (≥ 2 months after surgery) after perioperative administration of gabapentin and pregabalin and (2) performed a meta-analysis using studies that report sufficient data. A search of electronic databases (Medline, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, IPA, and CINAHL) for relevant English-language trials to June 2011 was conducted. ⋯ The present review supports the view that perioperative administration of gabapentin and pregabalin are effective in reducing the incidence of CPSP. Better-designed and appropriately powered clinical trials are needed to confirm these early findings.
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Anesthesia and analgesia · Aug 2012
Comparative StudyPharmacological studies of methoxycarbonyl etomidate's carboxylic acid metabolite.
Methoxycarbonyl etomidate (MOC-etomidate) is a rapidly metabolized and ultrashort-acting etomidate analog that does not produce prolonged adrenocortical suppression after bolus administration. Its metabolite (MOC-ECA) is a carboxylic acid whose pharmacology is undefined. We hypothesized that MOC-ECA possesses significantly lower pharmacological activity than MOC-etomidate, accounting for the latter's very brief duration of hypnotic action and inability to produce prolonged adrenocortical suppression after bolus administration. To test this hypothesis, we compared the potencies of MOC-ECA and MOC-etomidate in 3 biological assays. ⋯ In all 3 biological assays, MOC-ECA's potency was approximately 300-fold lower than that of MOC-etomidate.