Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2010
Randomized Controlled Trial Comparative StudyIntravenous lidocaine is as effective as epidural bupivacaine in reducing ileus duration, hospital stay, and pain after open colon resection: a randomized clinical trial.
Both postoperative epidural analgesia and intravenous (IV) infusion of local anesthetic have been shown to shorten ileus duration and hospital stay after colon surgery when compared with the use of systemic narcotics alone. However, they have not been compared directly with each other. ⋯ No differences were observed between groups in terms of return of bowel function, duration of hospital stay, and postoperative pain control, suggesting that IV infusion of local anesthetic may be an effective alternative to epidural therapy in patients in whom epidural anesthesia is contraindicated or not desired.
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Reg Anesth Pain Med · Jul 2010
Randomized Controlled TrialUltrasound provides a reliable test of local anesthetic spread.
We predicted that practitioners could identify injectate spread in a model of ultrasound-guided peripheral nerve block. ⋯ This study shows that ultrasound is a reliable method of detecting injectate spread in a gelatin phantom model.
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Reg Anesth Pain Med · Jul 2010
Randomized Controlled Trial Comparative StudyProtein balance in nondiabetic versus diabetic patients undergoing colon surgery: effect of epidural analgesia and amino acids.
Surgical injury provokes a stress response that is thought to be pronounced in patients with diabetes mellitus type 2 (DM2) leading to intensified catabolism. The aim of this study was to compare the effects of perioperative epidural analgesia (EDA) versus patient controlled analgesia (PCA) and amino acid infusion on postoperative metabolism in patients with and without DM2. ⋯ A short-term infusion of amino acids reduced protein breakdown, increased protein synthesis, and rendered protein balance positive. This anabolic effect was pronounced in diabetic patients with EDA compared with nondiabetic patients or PCA, respectively, and prevented an undesirable hyperglycemia.