British journal of anaesthesia
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Randomized Controlled Trial Comparative Study
Comparison of the effects of thoracic and lumbar epidural anaesthesia on induction and maintenance doses of propofol during total i.v. anaesthesia.
In this randomized, double-blind study, the effects of thoracic and lumbar epidural anaesthesia on the induction doses (IDs) and maintenance doses (MDs) of propofol during bispectral index (BIS) guided total i.v. anaesthesia were compared. ⋯ Similar segments blocked with epidural anaesthesia have resulted in similar ID. During maintenance, identical amounts of bupivacaine applied from different levels have resulted in different MD of propofol. The concentration of the epidural anaesthesia appears to play a more important role than the applied amount of the local anaesthetic.
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Review Meta Analysis
Acupuncture and related techniques for postoperative pain: a systematic review of randomized controlled trials.
Postoperative pain management remains a significant challenge for all healthcare providers. The objective of this systematic review was to quantitatively evaluate the efficacy of acupuncture and related techniques as adjunct analgesics for acute postoperative pain management. We searched the databases of Medline (1966-2007), CINAHL, The Cochrane Central Register of Controlled Trials (2006), and Scopus for randomized controlled trials (RCTs) using acupuncture for postoperative pain management. ⋯ Postoperative pain intensity (visual analogue scale, 0-100 mm) was also significantly decreased in the acupuncture group at 8 and 72 h compared with the control group. The acupuncture treatment group was associated with a lower incidence of opioid-related side-effects such as nausea (relative risk, RR: 0.67; 95% CI: 0.53, 0.86), dizziness (RR: 0.65; 95% CI: 0.52, 0.81), sedation (RR: 0.78; 95% CI: 0.61, 0.99), pruritus (RR: 0.75; 95% CI: 0.59, 0.96), and urinary retention (RR: 0.29; 95% CI: 0.12, 0.74). Perioperative acupuncture may be a useful adjunct for acute postoperative pain management.
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Randomized Controlled Trial Comparative Study
I.V. ropivacaine compared with lidocaine for the treatment of tinnitus.
I.V. lidocaine has been used to ameliorate tinnitus, but in general its effect has been limited. The longer acting local anaesthetic ropivacaine may be more effective. ⋯ Temporary clinically significant alleviation of tinnitus was observed only in a few individuals after both i.v. ropivacaine and lidocaine. The toxicity of ropivacaine limits its usefulness.
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Randomized Controlled Trial
Effect of landiolol on bispectral index and spectral entropy responses to tracheal intubation during propofol anaesthesia.
beta1-Adrenoceptor antagonists suppress the haemodynamic and arousal responses to tracheal intubation. The Entropy Module shows two spectral entropy-based indices, response entropy (RE) and state entropy (SE). The difference between RE and SE (RE-SE) may reflect nociception during general anaesthesia. In the present study, we investigated the effect of landiolol on entropy indices in response to tracheal intubation. ⋯ RE increased in response to tracheal intubation, whereas BIS and SE did not. Landiolol and remifentanil suppressed the increase in RE after tracheal intubation with significant inhibition of RE-SE difference.
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Clinical Trial
Propofol-based sedation regimen for infants and children undergoing ambulatory magnetic resonance imaging.
Propofol is widely used for infants and children requiring sedation for magnetic resonance imaging. However, increased doses of propofol may quickly lead to an unintended deep sedation and respiratory depression. Thus, an appropriate low dosage, which nevertheless ensures sufficient sleep for successful magnetic resonance imaging (MRI) completion, would probably minimize respiratory adverse events. We investigated the safety and efficacy of a low-dose propofol-based sedation regimen in a broad age range of children. ⋯ This sedation regimen provides the shortest induction time so far described, a rare demand for additional sedation, a low incidence of respiratory events, and a rapid recovery.