BMC anesthesiology
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Given the lack of global consensus on anesthesia selection for peritoneal dialysis catheter (PDC) placement via open surgery, this study investigates the safety and efficacy of combining local infiltration anesthesia (LIA) with monitored anesthesia care (MAC) in patients with end-stage renal disease (ESRD). ⋯ Open surgery for PDC placement under LIA + MAC is both safe and effective.
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Multicenter Study Comparative Study
Comparative efficacy of intrathecal morphine and adductor canal block in the knee arthroplasty population: a retrospective multi-centre cohort study.
Finding the balance of good postoperative analgesia while facilitiating mobility is important for a safe and satisfactory patient experience during Total Knee Arthroplasty (TKA). This study aimed to compare the efficacy of intrathecal morphine, adductor canal block, and their combination in optimizing pain management and postoperative recovery in TKA patients. This retrospective analysis of prospectively collected data evaluated postoperative pain scores, time to mobilisation, and length of hospital stay. ⋯ The combination of ITM and ACB in patients undergoing TKA provides improved postoperative analgesia with lower postoperative opioid requirement and earlier mobilization compared with ACB or ITM alone.
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Randomized Controlled Trial
Effects of dexamethasone on the EC50 of remifentanil combined with dexmedetomidine achieving analgesia during pancreatic extracorporeal shockwave lithotripsy: a prospective, randomized and controlled study.
In addition to their classic genomic effects, glucocorticoids also manifest rapid non genomic effects. We speculate that dexamethasone has the potential prompt onset of analgesic effects. The objective of this study is to investigate the influence of a single preoperative dose of dexamethasone on the half maximal effective concentration (EC50) of remifentanil when combined with dexmedetomidine for pain relief during pancreatic extracorporeal shockwave lithotripsy (P-ESWL). ⋯ Dexamethasone exerted analgesic effects with a rapid onset, and patients received dexamethasone 8 mg preoperative had a lower required EC50 of remifentanil during P-ESWL. It is also associated with reduced PONV in addition to reduced postoperative analgesic consumption in the first postoperative 24 h.
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Randomized Controlled Trial Comparative Study
The effect of three different nonpharmacological methods on cannulation success during peripheral intravenous catheter placement in the emergency unit: a randomized controlled trial.
Peripheral intravenous catheterization is frequently performed in emergency units, but it is a procedure which is difficult for healthcare professionals and painful for patients. The primary objective of the present study was to examine the effect on venous dilation, procedure duration and pain severity of local heat, cold and vibration applications performed on the intervention area before peripheral intravenous catheterization in adults. The second objective of the study was to examine the effects of age and gender variables on the participants' pain intensity levels. ⋯ It was determined that local cold application for one minute to the area of peripheral intravenous catheterization increased venous dilation, shortened application time, and reduced pain.
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Multicenter Study Observational Study
Association between delta anion gap/delta bicarbonate and outcome of surgical patients admitted to intensive care unit.
Patients undergoing high-risk surgeries with acid-based disorders are associated with poor outcomes. The screening of mixed acid-based metabolic disorders by calculating delta anion gap (AG)/delta bicarbonate (Bic) has a clinically relevant role in patients with high AG metabolic acidosis (MA), however its utility in individuals facing high-risk surgical procedures remains unclear. ⋯ In the postoperative time, patients with metabolic acidosis and no mixed disorders present higher ICU-Mortality and higher cardiovascular postoperative complications when compared with patients with combined hyperchloremia or alkalosis. Delta-AG/delta-Bic can be a useful tool to evaluate major clinical outcomes in this population.