Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of dexmedetomidine and midazolam sedation and antagonism of dexmedetomidine with atipamezole.
To evaluate the effects of dexmedetomidine, an alpha-2 agonist, as an intravenous sedative drug and the effects of atipamezole, an alpha-2 antagonist, on recovery. ⋯ Atipamezole is an effective antagonist for reversing psychomotor impairment following dexmedetomidine sedation.
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Meta Analysis
Postoperative patient-controlled analgesia: meta-analyses of initial randomized control trials.
To compare outcomes during conventional analgesia (as-needed intramuscular dosing) and patient-controlled analgesia (PCA) in postoperative patients by analyzing data from published comparative trials. ⋯ Patient preference strongly favors PCA over conventional analgesia. Patients using PCA also obtain better pain relief than those using conventional analgesia, without an increase in side effects. Favorable effect of PCA upon analgesic usage and length of hospital stay did not in the initial trials attain statistical significance. Nonetheless, the favorable trends in the mean effect sizes for both outcomes argue that further studies of both outcomes should be performed to determine whether the favorable impact of PCA upon either may become statistically significant if larger numbers of patients are enrolled.
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Randomized Controlled Trial Comparative Study Clinical Trial
Spinal or systemic analgesia after extensive spinal surgery: comparison between intrathecal morphine and intravenous fentanyl plus clonidine.
To compare two different methods of postoperative analgesia after extensive spinal fusion. ⋯ This study shows that there is a major risk of respiratory depression with a single intrathecal dose of morphine 0.3 mg to control postoperative pain after scoliosis surgery. Systemic clonidine-fentanyl may be a possible approach to the postoperative pain treatment of this surgery.
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Randomized Controlled Trial Clinical Trial
Intravenous clonidine fails to reduce postoperative meperidine requirements.
To investigate the effect of an additional postoperative intravenous (IV) clonidine infusion on meperidine requirements in the early postoperative period. ⋯ During the first 2 postoperative hours following cholecystectomy, postoperative meperidine intake could not be reduced by IV administration of clonidine 300 micrograms.
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Randomized Controlled Trial Clinical Trial
Role of the laryngeal mask airway in the immobile cervical spine.
To determine whether the laryngeal mask airway has a useful role in the airway management of patients whose cervical spines are immobilized in a rigid cervical collar. ⋯ The laryngeal mask airway compared favorably with an endotracheal tube in success rate, difficulty of insertion, and time to position correctly in this patient population. Although the laryngeal mask does not reliably protect against aspiration, we believe it may play a useful role if more conventional methods of airway management fail. Further studies in the trauma scenario are indicated.