Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study
Comparison of ropivacaine with and without fentanyl vs bupivacaine with fentanyl for postoperative epidural analgesia in bilateral total knee replacement surgery.
Pain after total knee replacement (TKR) interferes with early rehabilitation. Although the use of epidural bupivacaine in post-TKR patients is associated with effective analgesia, the associated motor blockade effect delays functional recovery. We compared analgesic efficacy and side effects of postoperative patient-controlled epidural analgesia (PCEA) with plain ropivacaine 0.1% with/without fentanyl 2.5 μg/mL vs plain bupivacaine 0.0625% with fentanyl 2.5 μg/mL in patients undergoing bilateral TKR. ⋯ After bilateral TKR, ropivacaine-fentanyl combination administered through a PCEA system resulted in "superior" analgesic efficacy, that is, pain relief without motor blockade, than "ropivacaine alone" (lesser pain relief) and bupivacaine-fentanyl (pain relief but with attendant motor blockade). Overall, the addition of fentanyl to epidural local anesthetic returned favorable postoperative analgesia profile and patient satisfaction with minor incidence of opioid-related side effects.
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Randomized Controlled Trial Comparative Study
Comparison of the macintosh and airtraq laryngoscopes in morbidly obese patients: a randomized and prospective study.
Morbid obesity is associated with a difficult management of the airway. There is no agreement on these patients being difficult to intubate, but if they are difficult to ventilate with facial mask, then the fast control of their airway becomes a priority. This study compares the quickness and success in tracheal intubation, glottic view, hemodynamic response, and complications from the use of the Macintosh and Airtraq laryngoscopes in morbidly obese patients for scheduled surgery. ⋯ Both devices allow quick and safe management of the airway. The Airtraq laryngoscope improved the glottic view by the modified Cormack-Lehane classification, reduced the need for additional maneuvers for tracheal intubation, and also reduced the degree of sympathetic stimulus detected by a minor increase in heart rate after tracheal intubation.
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Randomized Controlled Trial
Ultrasound-guided transversus abdominis plane block for postoperative analgesia in living liver donors: A prospective, randomized, double-blinded clinical trial.
Transversus abdominis plane (TAP) block is a peripheral nerve block that reduces postoperative pain, nausea, vomiting and the need for postoperative opioids following various types of abdominal surgery. The primary aim of the present study was to evaluate the effects of TAP block on postoperative analgesia and opioid consumption in living liver donors in whom a right "J" abdominal incision was used. ⋯ The TAP block reduced 24-h postoperative morphine consumption and contributed to analgesia in living liver donors who underwent upper abdominal wall incisions.
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Randomized Controlled Trial Comparative Study
Sevoflurane preserves regional cerebral oxygen saturation better than propofol: Randomized controlled trial.
To investigate possible effects of volatile induction and maintenance anesthesia with sevoflurane (VIMA) and total intravenous anesthesia with propofol (TIVA) on regional cerebral oxygen saturation (rcSo2) during laparoscopic cholecystectomy. ⋯ VIMA technique provides significantly (4%-11%) higher rcSO2 values during general anesthesia for laparoscopic cholecystectomy, when compared with TIVA and also provides significantly less number of critical rcSO2 decreases.
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Randomized Controlled Trial
Effects of dexmedetomidine administered for postoperative analgesia on sleep quality in patients undergoing abdominal hysterectomy.
To evaluate the effects of postoperative dexmedetomidine infusion on sleep quality in patients undergoing abdominal hysterectomy. ⋯ Dexmedetomidine infusion not only offers effective analgesia but also improves postoperative sleep quality in patients undergoing hysterectomy.