Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Sep 2009
Randomized Controlled TrialAdding gabapentin to a multimodal regimen does not reduce acute pain, opioid consumption or chronic pain after total hip arthroplasty.
Gabapentin (GPN) is effective in reducing post-operative pain and opioid consumption, but its effects with regional anesthesia for total hip arthroplasty (THA) are not known. We designed this study to determine whether (1) gabapentin administration reduces pain and opioid use after THA using a multimodal analgesic regimen including spinal anesthesia; (2) pre-operative administration of gabapentin is more effective than post-operative administration. ⋯ A single 600 mg dose of gabapentin given pre-operatively or post-operatively does not reduce morphine consumption or pain scores in hospital or at 6 months after hip arthroplasty within the context of spinal anesthesia and a robust multimodal analgesia regimen.
-
Acta Anaesthesiol Scand · Sep 2009
Randomized Controlled TrialThe addition of fentanyl to 1.5 mg/ml ropivacaine has no advantage for paediatric epidural analgesia.
Epidural opioids are frequently combined with local anaesthetics for an additive antinociceptive effect. We investigated the efficacy of epidural fentanyl to 1.25 or 1.5 mg/ml ropivacaine for post-operative epidural analgesia in children. ⋯ The addition of 0.2 mcg/kg/h fentanyl to 1.5 mg/ml ropivacaine increased the incidence of side effects without improvement of analgesia in infants and children undergoing hypospadias repair. The use of plain 1.25 mg/ml ropivacaine increased the need for rescue analgesia and this could be compensated by addition of fentanyl.
-
Acta Anaesthesiol Scand · Sep 2009
Predictors of cardiac events in high-risk patients undergoing emergency surgery.
The aim of this study was to determine the incidence of myocardial damage and left ventricular myocardial dysfunction and their influence on outcome in high-risk patients undergoing non-elective surgery. ⋯ Myocardial damage is common in a high-risk population undergoing unscheduled surgery. These results suggest a close correlation between myocardial damage in the post-operative period and increased concentration of NT-proBNP before surgery. The combinations of TnI and NT-proBNP are reliable markers for monitoring patients at risk in the peri-operative period as well as useful tools in our risk assessment pre-operatively in emergency surgery.
-
Acta Anaesthesiol Scand · Sep 2009
Randomized Controlled TrialIntravenous magnesium sulfate for post-operative pain in patients undergoing lower limb orthopedic surgery.
This study looks at the effect of supplementary intravenous magnesium sulfate on acute pain when administered in patients undergoing lower limb orthopedic surgery using spinal anesthesia with bupivacaine. ⋯ Intravenous magnesium sulfate can serve as a supplementary analgesic therapy to suppress the acute post-operative pain, leading to less morphine requirements in the first 24 h.
-
Acta Anaesthesiol Scand · Sep 2009
Randomized Controlled TrialPulse oximeter perfusion index as an early indicator of sympathectomy after epidural anesthesia.
The pulse oximeter perfusion index (PI) has been used to indicate sympathectomy-induced vasodilatation. We hypothesized that pulse oximeter PI provides an earlier and clearer indication of sympathectomy following epidural anesthesia than skin temperature and arterial pressure. ⋯ PI was an earlier, clearer and more sensitive indicator of the development of epidural-induced sympathectomy than either skin temperature or MAP.