European journal of anaesthesiology
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Randomized Controlled Trial Clinical Trial
Evaluation of a local anaesthesia regimen using a subphrenic catheter after gynaecological laparoscopy.
The purpose of intraperitoneal local anaesthetic administration is to block visceral nociceptive conduction and to provide an additional route of analgesia. The present study evaluates the effects of sequential injections of bupivacaine on postoperative pain through a subphrenic catheter. ⋯ This study demonstrates that intraperitoneal bupivacaine may reduce pain on coughing in the early postoperative period and the consumption of analgesics postoperatively. The subphrenic catheter technique had no impact upon pain at rest and shoulder-tip pain after gynaecological laparoscopy.
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Randomized Controlled Trial Clinical Trial
Low-dose ketamine failed to spare morphine after a remifentanil-based anaesthesia for ear, nose and throat surgery.
Ketamine has been claimed to prevent acute opioid tolerance and hyperalgesia following acute exposure to opioids and its use has been proposed to decrease postoperative morphine consumption. ⋯ Low-dose ketamine added to a remifentanil-based propofol anaesthesia did not reduce morphine consumption after major ENT surgery.
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Recently published literature shows that most patients experience a variety of visual sensations during cataract surgery under local anaesthesia. Most patients (80-100%) retain at least some light perception in the operated eye and many also experience a variety of other visual sensations during cataract surgery under regional ophthalmic anaesthesia (retrobulbar, peribulbar and sub-Tenon's blocks) or topical anaesthesia. The visual sensations experienced include perception of movements, flashes, colours, changes in brightness, or the sight of surgical instruments, the surgeon's hands or fingers, or even the surgeon. ⋯ Besides increasing the risk of intraoperative complications, a frightening visual experience may decrease patient satisfaction. Appropriate preoperative counselling has been shown to be effective in reducing the patients' fear. As most patients retain some visual function during cataract surgery under local anaesthesia, anaesthesia providers should be mindful of this phenomenon and offer appropriate preoperative information and counselling to their patients.
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Letter Randomized Controlled Trial Comparative Study Clinical Trial
Brachial plexus block with ropivacaine and bupivacaine for the formation of arteriovenous fistula in patients with end-stage renal failure.
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Randomized Controlled Trial Comparative Study Clinical Trial
Postoperative condition after the use of remifentanil with a small dose of piritramide compared with a fentanyl-based protocol in patients undergoing craniotomy.
The use of remifentanil requires other analgesics for postoperative pain relief compared to fentanyl in patients undergoing craniotomy. This could possibly reduce the postoperative advantages of this short-acting opioid. ⋯ Despite the intraoperative use of piritramide in the remifentanil group, patients experienced more pain postoperatively. A significant influence of age on pain intensity was found. The use of remifentanil with a small dose of piritramide of 0.1 mg kg(-1) has no evident advantage over the use of fentanyl considering the postoperative conditions after craniotomy.