Journal of clinical anesthesia
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Serotonin (5-hydroxytryptamine) is an important biogenic amine that fulfills the role of neurotransmitter and neuromodulator. It has been a focus of interest during the last decade. Its diversity of pharmacologic actions is related to a wide variety of receptors and effector mechanisms. ⋯ Serotonin reuptake inhibitors are of particular clinical importance in the treatment of psychological illness. Future use of these drugs is also envisioned in the treatment of certain types of pain syndromes. Awareness of the serotonergic drugs and the recognition of possible drug interactions among drugs that influence serotonergic mechanisms in humans are becoming increasingly important in the practice of anesthesiology.
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Randomized Controlled Trial Clinical Trial
Effect of varying intravenous patient-controlled analgesia dose and lockout interval while maintaining a constant hourly maximum dose.
To investigate the effect on the use of intravenous patient-controlled analgesia (PCA) of varying the dose (D) and lockout interval (LI) while keeping the hourly maximum dose constant. ⋯ The use of 1.0 mg with a 6-minute lockout may represent appropriate dose titration because this group obtained equivalent analgesia, morphine use, and side effects as the two larger dose and lockout groups. However, the increased number of PCA attempts and missed attempts may reflect lower satisfaction with PCA therapy.
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Randomized Controlled Trial Clinical Trial
The efficacy of single-dose aprotinin 2 million KIU in reducing blood loss and its impact on the incidence of deep venous thrombosis in patients undergoing total hip replacement surgery.
To evaluate the efficacy of a 2 million KIU single dose of aprotinin on blood loss, transfusion requirements, and incidence of deep venous thrombosis (DVT) in patients undergoing total hip replacement surgery. ⋯ A single 2 million KIU bolus dose of aprotinin does not reduce perioperative blood loss or transfusion requirements. Aprotinin therapy, when used in conjunction with other antithrombotic therapies, does not increase the incidence of DVT after major orthopedic surgery.
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Comparative Study
Discordance between patient self-reported visual analog scale pain scores and observed pain-related behavior in older children after surgery.
To assess the correlation in an older pediatric population between patient self-reported visual analog scale (VAS) pain scores and observational pain-related behavior scores. ⋯ A tenuous relationship may exist between on older child's own perception of pain intensity and his or her behavioral expression of that pain as interpreted by a health care provider.
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The occurrence of neuromuscular blockade and the resulting potentiation of muscle relaxants during magnesium sulfate (MgSO4) administration is well known. However, a method to differentiate the neuromuscular block induced by magnesium from that induced by curariform nondepolarizing muscle relaxant in the clinical setting has never been reported. ⋯ We believe this is a remarkable potentiation on record in the literature. We also describe a new, noninvasive method to assess magnesium-induced neuromuscular block when curariform muscle relaxant was given simultaneously.