Journal of anesthesia
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Journal of anesthesia · Dec 2017
Randomized Controlled TrialEffects of pregabalin on postoperative pain after hysterectomy under spinal anesthesia with intrathecal morphine: a randomized controlled trial.
To determine if preoperative pregabalin could decrease 24-h postoperative morphine consumption after spinal anesthesia with intrathecal morphine compared with placebo. ⋯ A single preoperative dose of pregabalin 150 mg did not reduce 24-h postoperative morphine consumption or pain scores or prolong the time to first analgesic rescue in spinal anesthesia with intrathecal morphine.
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Journal of anesthesia · Dec 2017
Important role of calcium chloride in preventing carbon monoxide generation during desflurane degradation with alkali hydroxide-free carbon dioxide absorbents.
We investigated whether calcium chloride (CaCl2), a supplementary additive in carbon dioxide (CO2) absorbents, could affect carbon monoxide (CO) production caused by desflurane degradation, using a Japanese alkali-free CO2 absorbent Yabashi Lime®-f (YL-f), its CaCl2-free and 1% CaCl2-added derivatives, and other commercially available alkali-free absorbents with or without CaCl2. The reaction between 1 L of desflurane gas (3-10%) and 20 g of desiccated specimen was performed in an artificial closed-circuit anesthesia system for 3 min at 20 or 40 °C. The CO concentration was measured using a gas chromatograph equipped with a semiconductor sensor detector. ⋯ Compared with YL-f, the CaCl2-free derivative caused the production of significantly more CO, while the 1% CaCl2-added derivative caused the production of a comparable amount of CO. These phenomena were confirmed using commercially available absorbents AMSORB® PLUS, an alkali-free absorbent with CaCl2, and LoFloSorb™, an alkali-free absorbent without CaCl2. These results suggest that CaCl2 plays an important role in preventing CO generation caused by desflurane degradation with alkali hydroxide-free CO2 absorbents like YL-f.
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Journal of anesthesia · Dec 2017
Case ReportsEpidural patch with autologous platelet rich plasma: a novel approach.
We aimed to perform an epidural patch using platelet rich plasma (PRP), which has the potential to regenerate and heal tissues via degranulation of platelets, in a 34-year-old parturient suffering from persistent post-dural puncture headache (PDPH) after failed epidural blood patch (EBP). After her admission to our unit, we reconfirmed the clinical and radiologic diagnosis of PDPH. ⋯ Clinical and radiological improvements were observed 1 week after the epidural patch using autologous PRP. Therefore, we recommend using autologous PRP for epidural patching in patients with incomplete recovery after standard EBP as a novel successful approach.