Journal of anesthesia
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Journal of anesthesia · Oct 2014
Randomized Controlled TrialIntrathecal ketorolac does not improve acute or chronic pain after hip arthroplasty: a randomized controlled trial.
Hypersensitivity to mechanical stimuli following surgery has been reported in patients who subsequently develop chronic pain after surgery. In animals, peripheral injury increases prostaglandin production in the spinal cord, and spinal cyclooxygenase inhibitors reduce hypersensitivity after injury. We therefore tested the hypothesis that spinal ketorolac reduces hypersensitivity and acute and chronic pain after hip arthroplasty ( www.clinicaltrials.gov NCT 00621530). ⋯ The groups did not differ in acute pain, acute opioid use, or pain incidence or severity at 2 and 6 months after surgery. There were no serious adverse events. Our results suggest that a single spinal dose of ketorolac does not substantially reduce acute surgical pain and is thus unlikely to reduce the risk of persistent incisional pain.
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Journal of anesthesia · Oct 2014
Editorial CommentAre videolaryngoscopes useful for nasotracheal intubation?
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Journal of anesthesia · Oct 2014
Clinical evaluation of hyponatremia and hypovolemia in critically ill adult neurologic patients: contribution of the use of cumulative balance of sodium.
Knowledge of the cumulative balance of sodium (CBS) is important for the diagnosis of salt disorders and water homeostasis and has the potential to predict hypovolemic status in acute neurological patients. However, an extensive application of the use of CBS is still lacking in the intensive care setting, where salt and water homeostasis represents a priority. ⋯ CBS is likely to be a useful parameter in the diagnosis of CSWS and a surrogate parameter for estimating hypovolemia in acute neurological patients.
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Journal of anesthesia · Oct 2014
Randomized Controlled TrialHemodynamic effects of topical lidocaine on the laryngoscope blade and trachea during endotracheal intubation: a prospective, double-blind, randomized study.
Minimizing hemodynamic changes during the peri-intubation period is a concern for anesthesiologists. We investigated the effect of lidocaine sprayed on the laryngoscope blade and trachea on hemodynamics during direct laryngoscopic intubation. ⋯ Lidocaine sprayed on the laryngoscope blade and/or trachea reduced the hemodynamic response to laryngoscopic intubation during the post-intubation period following anesthetic induction with remifentanil and propofol using a TCI device.
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Journal of anesthesia · Oct 2014
Randomized Controlled Trial Comparative StudySevoflurane/propofol coadministration provides better recovery than sevoflurane in combined general/epidural anesthesia: a randomized clinical trial.
A classic general anesthesia is performed by induction with an intravenous hypnotic (such as propofol) and maintenance with a volatile anesthetic (such as sevoflurane). The aim of the present study was to compare the effects of a propofol/sevoflurane maintenance regimen with that of a sevoflurane regimen on recovery profiles. ⋯ Compared to sevoflurane maintenance, coadministration of propofol and sevoflurane provides faster awakening and extubation with a low incidence of emergence coughing and agitation.