European journal of anaesthesiology
-
Randomized Controlled Trial
Antiemetic effect of ondansetron 0.2 mg mL-1 in PCA morphine solution.
To study the effect of 0.2 mg mL-1 of ondansetron added to morphine patient-controlled analgesia solution after a 4 mg loading dose on the incidence and severity of postoperative nausea and vomiting. ⋯ Ondansetron 4 mg plus 0.2 mg mL-1 given with PCA morphine can reduce nausea and vomiting thus improving patient satisfaction.
-
Allodynia is a common and disabling symptom in many patients with neuropathic pain. Whereas quantification of pain mostly depends on subjective pain reports, allodynia can also be measured objectively with quantitative sensory testing. In this pilot study, we investigated the clinical relevance of quantitative sensory testing with Von Frey monofilaments in patients with allodynia as a consequence of a neuropathic pain syndrome, by means of correlating subjective pain scores with pain thresholds obtained with quantitative sensory testing. ⋯ These preliminary findings indicate clinical relevance of quantitative sensory testing with Von Frey monofilaments in the quantification of allodynia in patients with neuropathic pain, although confirmation of our data is still required in further studies to position this method of quantitative sensory testing as a valuable tool, for example, in the evaluation of therapeutic interventions for neuropathic pain.
-
Mortality prediction systems have been calculated and validated from large mixed ICU populations. However, in daily practice it is often more important to know how a model performs in a patient subgroup at a specific ICU. Thus, we assessed the performance of three mortality prediction models in four well-defined patient groups in one centre. ⋯ In our surgical ICU, Mortality Probability Model II (24 h) performed slightly better than Simplified Acute Physiology Score II in terms of overall mortality prediction and discrimination; Injury Severity Score was the worst model for mortality prediction in trauma patients.
-
Comparative Study
Differential neurotoxicity of tricyclic antidepressants and novel derivatives in vitro in a dorsal root ganglion cell culture model.
Tricyclic antidepressants are commonly employed orally to treat major depressive disorders and have been shown to be of substantial benefit in various chronic pain conditions. Among other properties they are potent Na+ channel blockers in vitro and show local anaesthetic properties in vivo. The present study aimed to determine their differential neurotoxicity, and that of novel derivatives as prerequisite for their potential use in regional anaesthesia. ⋯ Tricyclic antidepressants and novel derivatives thereof show differential neurotoxic potential in vitro. The rank order of toxicity relative to sodium channel blocking potency was desipramine < amitriptyline < N-methyl amitriptyline < doxepin < trimipramine < imipramine < N-methyl doxepin < N-propyl doxepin.
-
Historical Article
The effect of the First World War (1914-1918) on the development of British anaesthesia.
One of the greatest but also most unfortunate ironies in life is how modern medicine owes some of its existence to the deadly cancer of war. For those whose image of armed conflict is one of disease, death and destruction, this will no doubt be a surprise. However, these very conditions have allowed military surgeons and physicians unparalleled opportunities to experiment and develop using large and dependent populations of potential patients. ⋯ This work led to the popularity of nitrous oxide, ether and oxygen, which in turn stimulated interest in anaesthesia machines. Finally, the treating of facial wounds in casualties at the Queen's Hospital for facial and jaw injuries at Sidcup, highlighted the possibility of endotracheal intubation, a technique that had a drastic effect on the administration of anaesthetics. Although there were no new wonder anaesthetics, something which would not occur until the neuromuscular blocking drugs of the 1940s, many of these concepts moved into civilian anaesthesia and enabled British anaesthesia to be at the forefront of anaesthesia development for much of the twentieth century.