Journal of clinical anesthesia
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Multicenter Study Observational Study
Remifentanil and worse patient-reported outcomes regarding postoperative pain management after thyroidectomy.
Intraoperative remifentanil has been associated with postoperative hyperalgesia, higher visual analogic pain scores, and increased postoperative morphine consumption. However, this has not been investigated from patient's perspective by using a patient-reported outcomes (PROs) approach with a validated questionnaire. ⋯ Our study suggests that remifentanil-based anesthesia is associated with worse pain-related PROs in patients undergoing thyroidectomy despite more frequent intraoperative analgesic administration. This study adds further evidence to the growing literature about opioid- and remifentanil-induced hyperalgesia.
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Randomized Controlled Trial
A randomized placebo-controlled study of preoperative pregabalin for postoperative analgesia in patients with spinal surgery.
To determine whether single preoperative administration of 2 different doses of pregabalin (75 and 150 mg) could decrease postoperative pain intensity and opioid consumption following posterior lumbar interbody fusion surgery. ⋯ Single preoperative administration of 150 mg of pregabalin 2 hours prior to surgery reduced postoperative pain intensity and morphine consumption compared with 5 mg diazepam in patients who underwent posterior lumbar interbody fusion.
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Comparative Study Controlled Clinical Trial
Prone position results in enhanced pressor response to ephedrine compared with supine position during general anesthesia.
To elucidate and compare the pressor response to ephedrine in the prone or supine position during general anesthesia (GA). ⋯ Compared to the supine position, the prone position could augment the pressor response to IV ephedrine during GA. Further studies are recommended to identify its association with other confounding factors such as surgery type or duration, patient history of cardiovascular disease, or patient hydration status.
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As the patient population with deep brain stimulators grows, medical personnel need to be comfortable managing these patients because they will likely encounter them in practice. Caring for a patient with a deep brain stimulator during surgery or a procedure requires technical knowledge of the device and its possible interactions in order to take the correct precautionary measures. Here we discuss the key issues and questions that should be covered in every preanesthetic evaluation visit of a patient with a deep brain stimulator along with an evaluation checklist.
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Randomized Controlled Trial
Two methods for teaching basic upper airway sonography.
The purpose of this study was to evaluate and compare hands-on gel phantom versus instructional video teaching methods to improve anesthesia residents and staff members' ability to correctly identify airway structures using ultrasound on a human volunteer. ⋯ Use of either a low cost, airway gel phantom training model for hands-on training or a simple instructional teaching video can be used in a single training session to improve staff anesthesiologist and anesthesia resident knowledge and skills for ultrasound identification of upper airway anatomy.