Anesthesia and analgesia
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Anesthesia and analgesia · Aug 2015
Involvement of Opioid Receptors in the Lipid Rescue of Bupivacaine-Induced Cardiotoxicity.
Lipid emulsion (LE) has been successfully used for resuscitation of local anesthetic cardiotoxicity caused by bupivacaine overdose. Opioid receptors have been shown to play a key role in cardio protection. We explored whether this rescue action of LE is mediated through opioid receptors. ⋯ Our data highlight the involvement of peripheral δ- and κ-opioid receptors in the rescue action of LE.
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Anesthesia and analgesia · Aug 2015
Multicenter Study Observational StudyThe RECITE Study: A Canadian Prospective, Multicenter Study of the Incidence and Severity of Residual Neuromuscular Blockade.
Postoperative residual neuromuscular blockade continues to be common and is experienced by the majority of patients receiving muscle relaxants.
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Anesthesia and analgesia · Aug 2015
Randomized Controlled Trial Multicenter Study Comparative StudyRationale and Design of the Balanced Anesthesia Study: A Prospective Randomized Clinical Trial of Two Levels of Anesthetic Depth on Patient Outcome After Major Surgery.
An association between relatively deep anesthesia, as guided by the bispectral index (BIS), and increased postoperative mortality has been demonstrated in 6 of 8 published observational studies, but association does not necessarily mean causality. Small clinical trials of anesthetic depth have demonstrated increased delirium and postoperative cognitive dysfunction in patients who were relatively deeply anesthetized, but have been inadequately powered to study mortality. A large-scale randomized study is required to determine whether causality exists. ⋯ This randomized controlled trial should definitively answer the question of whether titrating anesthetic depth makes a difference to patient outcome in a vulnerable patient group.
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Anesthesia and analgesia · Aug 2015
Randomized Controlled Trial Comparative StudyTransversus Abdominis Plane Block Versus Caudal Epidural for Lower Abdominal Surgery in Children: A Double-Blinded Randomized Controlled Trial.
TAP block provides superior analgesia to caudal block, though is less effective at preventing bladder spasms after paediatric lower abdominal surgery.
pearl -
Anesthesia and analgesia · Aug 2015
Comparative StudyThe Relationship of Body Mass Index with the Incidence of Postdural Puncture Headache in Parturients.
Unintentional dural puncture is a known risk after epidural or combined spinal-epidural procedures, occurring in approximately 1% of labor epidural catheters placed in parturients with normal body habitus but may be as high as 4% in morbidly obese parturients. Anecdotal experience and limited publications suggest that an inverse relationship between body mass index (BMI) and postdural puncture headache (PDPH) may exist. We hypothesized that parturients with increased BMI have a lower incidence of PDPH than those with a lower BMI after unintentional dural puncture. ⋯ The findings are consistent with previous reports of decreased PDPH incidence after unintentional dural puncture in parturients with an increased BMI, even after controlling for pushing during labor. Severity of headache and need for epidural blood patch treatment were similar in low and high BMI groups.