Journal of anesthesia
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Journal of anesthesia · Jun 2013
Randomized Controlled TrialOral administration of aprepitant to prevent postoperative nausea in highly susceptible patients after gynecological laparoscopy.
The use of opioids following surgery is associated with a high incidence of postoperative nausea and vomiting (PONV). We conducted a prospective, randomized, double-blind, placebo-controlled study to investigate the effect of orally administered aprepitant, a neurokinin-1 receptor antagonist, for reducing PONV in patients with fentanyl-based, patient-controlled analgesia (PCA) given intravenously after gynecological laparoscopy. ⋯ Aprepitant 80 mg orally was effective in lowering the incidence of PONV in the first 48 h after anesthesia in patients receiving fentanyl-based PCA after gynecological laparoscopy.
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Journal of anesthesia · Jun 2013
Randomized Controlled TrialA prospective, randomized, double-blind study to compare the efficacy of lidocaine + metoclopramide and lidocaine + ketamine combinations in preventing pain on propofol injection.
Propofol injection is known to cause distressing pain, and various methods have been used to decrease this pain. We investigated the efficacy of the lidocaine + metoclopramide and lidocaine + ketamine combinations on modulating propofol injection pain. ⋯ The lidocaine-ketamine combination is most effective for decreasing the pain on propofol injection.
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Journal of anesthesia · Jun 2013
ReviewResuscitation after hemorrhagic shock: the effect on the liver--a review of experimental data.
The liver is currently considered to be one of the first organs to be subjected to the hypoxic insult inflicted by hemorrhagic shock. The oxidative injury caused by resuscitation also targets the liver and can lead to malfunction and the eventual failure of this organ. Each of the various fluids, vasoactive drugs, and pharmacologic substances used for resuscitation has its own distinct effect(s) on the liver, and the anesthetic agents used during surgical resuscitation also have an impact on hepatocytes. ⋯ The effect of a specific resuscitation agent on the liver is assessed mainly by measuring apoptotic pathway regulators and inflammation-induced indicators. Apart from a wide range of pharmacological substances, modifications of Ringer's Lactate, colloids, and pyruvate provide protection to the liver after hemorrhage and resuscitation. In this setting, it is of paramount importance that the treating physician recognize those agents that may attenuate liver injury and avoid using those which inflict additional damage.
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Journal of anesthesia · Jun 2013
Randomized Controlled TrialLevosimendan is superior to dobutamine as an inodilator in the treatment of pulmonary hypertension for children undergoing cardiac surgery.
To compare the effectiveness of levosimendan and dobutamine in reducing pulmonary artery pressure (PAP) and increasing cardiac output for children undergoing cardiac surgery. ⋯ Levosimendan is better than dobutamine for treatment of pulmonary hypertension of children undergoing cardiac surgery.