Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Comparative Study Clinical Trial
Ropivacaine plasma concentrations are similar during continuous lumbar plexus blockade using the anterior three-in-one and the posterior psoas compartment techniques.
To compare ropivacaine blood concentrations obtained after a continuous lumbar plexus block performed either by the anterior three-in-one femoral (FEM) technique or the posterior (psoas compartment; PSOAS) technique. ⋯ Although the posterior PSOAS block results in higher early plasma concentrations of local anesthetic than the anterior three-in-one FEM block, both techniques are equivalent with regards to their potential toxicity when a continuous infusion is administered. Local anesthetic accumulation occurs with an infusion of ropivacaine 0.2% at 12 mL.hr(-1) and can lead to potentially dangerous concentrations at 48 hr.
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Randomized Controlled Trial Clinical Trial
Tranexamic acid reduces the need for allogenic red blood cell transfusions in patients undergoing total hip replacement.
This prospective randomized double-blind trial evaluates the efficacy of tranexamic acid (TA) to decrease blood losses and red blood cell transfusions in patients undergoing primary unilateral total hip replacement (THR). ⋯ TA did not change measured blood losses but reduced red blood cell transfusion requirements in patients undergoing primary unilateral THR.
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Randomized Controlled Trial Comparative Study Clinical Trial
Remifentanil provides better analgesia than alfentanil during breast biopsy surgery under monitored anesthesia care.
To compare the analgesic effects of remifentanil and alfentanil during breast biopsy under monitored anesthesia care (MAC). ⋯ Remifentanil was a better opioid choice than alfentanil for breast biopsy under MAC at the doses studied, but it did not increase the rapidity in which patients recovered postoperatively.
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Randomized Controlled Trial Clinical Trial
A risk adapted approach reduces the overall institutional incidence of postoperative nausea and vomiting.
Routine prophylactic antiemetic treatment of surgical patients appears justified only in case of an increased risk of postoperative nausea and vomiting (PONV). The objective of this investigation was to assess the feasibility and efficacy of a dichotomized risk score adapted management of PONV based on ondansetron prophylaxis and treatment with respect to the overall institutional rate of PONV. ⋯ Providing antiemetic prophylaxis with ondansetron to high-risk patients strictly based on a simplified risk score can reduce the overall institutional rate of PONV. However, classifying patients into two groups while using ondansetron as the single antiemetic in the high-risk group appears to be of limited efficacy as the incidence of PONV in high-risk patients is still double that of low-risk patients.
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Randomized Controlled Trial Comparative Study Clinical Trial
The posterior lumbar plexus (psoas compartment) block and the three-in-one femoral nerve block provide similar postoperative analgesia after total knee replacement.
To compare the efficacy of a continuous posterior lumbar plexus (PSOAS) block to a continuous three-in-one femoral nerve (FEM) block in patients undergoing primary total knee replacement (TKR). ⋯ Both continuous PSOAS block and continuous three-in-one FEM block provided better analgesia than PCA but no differences were seen between the two regional techniques.