Anesthesia and analgesia
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Anesthesia and analgesia · Oct 2014
Randomized Controlled Trial Multicenter Study Comparative StudyA Safety and Efficacy Evaluation of Hemoglobin-Based Oxygen Carrier HBOC-201 in a Randomized, Multicenter Red Blood Cell-Controlled Trial in Noncardiac Surgery Patients.
Small study of data collected more than 15 years ago suggests hemoglobin-based oxygen carrier HBOC-201 may reduce transfusion requirements in a non-cardiac surgery cohort. Although no significant difference in adverse events or mortality, a trend to higher incidence of both among the HBOC-201 group requires a much larger trial to be conducted before any conclusion regarding safety of such a novel therapy can be made.
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Anesthesia and analgesia · Oct 2014
Meta AnalysisWhat Epidural Opioid Results in the Best Analgesia Outcomes and Fewest Side Effects After Surgery?: A Meta-Analysis of Randomized Controlled Trials.
Epidural opioids are widely used for central neuraxial blockade and postoperative analgesia. However, differences in analgesic efficacy and side effect rates among individual opioids remain controversial. ⋯ Analgesic outcome, in terms of VAS pain score, was similar between the epidural opioids studied. These similarities in analgesia may reflect the common practices of concurrently using epidural local anesthetics with the opioids and titrating infusion rates according to a patient's pain status. With respect to side effects, the incidence of PONV and possibly pruritus was higher with morphine compared with fentanyl, despite there being similar total opioid consumption between those groups.
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Anesthesia and analgesia · Oct 2014
Comparative StudyOutcomes After Radical Prostatectomy for Cancer: A Comparison Between General Anesthesia and Epidural Anesthesia with Fentanyl Analgesia: A Matched Cohort Study.
Regional anesthesia and analgesia confers no oncological-outcome benefit compared with general anesthesia for radical prostatectomy.
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Anesthesia and analgesia · Oct 2014
Safety and Efficacy of Drug-Induced Sleep Endoscopy Using a Probability Ramp Propofol Infusion System in Patients with Severe Obstructive Sleep Apnea.
Drug-induced sleep endoscopy (DISE) uses sedative-hypnotics to induce moderate obstruction in sleep apnea patients, thereby facilitating anatomic assessment of obstructive physiology. Implementation of DISE with propofol requires a dosing strategy that reliably and efficiently produces obstruction while minimizing oxygen desaturation. ⋯ A propofol infusion strategy that requires limited experience with propofol dose selection and only 1 pump dosing change reliably produced airway obstruction in patients with severe sleep apnea. Clinical obstruction was achieved faster than target-controlled infusion-based systems for similar procedures reported in the literature. The observed degree of oxygen desaturation in the model system was within a clinically acceptable range.
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Recent studies have revealed the antinociceptive effects of glycine transporter (GlyT) inhibitors in neuropathic pain models such as sciatic nerve-injured and diabetic animals. Bone cancer can cause the most severe pain according to complex mechanisms in which a neuropathic element is included. Bone cancer modifies the analgesic action of opioids and limits their effectiveness, and thus novel medicament for bone cancer pain is desired. ⋯ GlyT inhibitors with or without morphine may be a new strategy for the treatment of bone cancer pain and lead to further investigations of the mechanisms underlying the development of bone cancer pain.