Journal of anaesthesiology, clinical pharmacology
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J Anaesthesiol Clin Pharmacol · Apr 2018
Comparison of pregabalin with gabapentin as preemptive analgesic in lumbar spine surgery.
Analgesic effect of gabapentin and pregabalin is well-defined in the treatment of neuropathic pain. Postoperative pain after lumbar spine surgery limits the function of patients in the postoperative period, for which the search for ideal analgesic goes on. The aim of the present study was to compare pregabalin and gabapentin as a pre-emptive analgesic in elective lumbar spine surgeries. ⋯ Though both study drugs had produced prolonged postoperative analgesia compared to placebo, pregabalin had better analgesic profile in postoperative period than gabapentin.
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J Anaesthesiol Clin Pharmacol · Apr 2018
ReviewPharmacogenomics of analgesics in anesthesia practice: A current update of literature.
The field of pharmacogenomics seeks to understand how an individual's unique gene sequence can affect their response to certain drugs. It is particularly relevant in anesthesia when the interindividual response to pain medication is essential. Codeine and tramadol are prodrugs metabolized by CYP2D6, polymorphisms of which can cause dangerous or even fatal levels of their metabolites, or decrease the level of metabolites to decrease their analgesic effect. ⋯ Certain haplotypes of COMT have been demonstrated to have an effect on opioid requirements. The OPRM1 gene codes for the mu-opioid receptor, and there is conflicting data regarding its effect on analgesia and opioid requirements. Overall, there is a fair amount of conflicting data in the above topics, suggesting that there is still a lot of research to be done on these topics, and that pain perception is multifactorial, likely including many common genetic variants.
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J Anaesthesiol Clin Pharmacol · Apr 2018
Thoracic paravertebral block for the anesthetic management of percutaneous radiofrequency ablation of liver tumors.
Percutaneous radiofrequency ablation (PRFA) is a minimally invasive treatment for hepatic tumors. We assessed and compared the efficacy of right thoracic paravertebral block (TPVB) with that of local anesthetic infiltration for the anesthetic management of PRFA of liver tumors. ⋯ Right TPVB with sedation is an effective and safe anesthetic technique for the management of PRFA procedure of hepatic tumors. It is more effective than local anesthesia with sedation in relieving pain during PRFA procedure of hepatic tumors.
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J Anaesthesiol Clin Pharmacol · Apr 2018
Comparison of dermatomal sensory block following ultrasound-guided transversus abdominis plane block by the lateral and posterior approaches: A randomized controlled trial.
Ultrasound (US)-guided transversus abdominis plane (TAP) block is used as a part of a multimodal analgesic regimen in the postoperative period. Lateral approach TAP block (LTAP) has been widely used for postoperative analgesia after lower abdominal surgeries. Posterior approach TAP block (PTAP), which is achieved by more posterior blockade of the anterior ramus of the spinal nerve, also provides profound postoperative analgesia after transverse lower abdominal incision. We investigated the dermatomal sensory block following LTAP and PTAP under US guidance. ⋯ PTAP produced a sensory block that involved a greater number of dermatomes and involvement of more cephalad dermatome blocked to sharp touch, compared with LTAP under US guidance.
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J Anaesthesiol Clin Pharmacol · Apr 2018
A double-blind randomized control trial to compare the effect of varying doses of intrathecal fentanyl on clinical efficacy and side effects in parturients undergoing cesarean section.
It is a common practice to add intrathecal lipophilic opioids to local anesthetics to improve the quality of subarachnoid block. This study was designed to find a dose of intrathecal fentanyl, which can improve the quality of surgical anesthesia with minimal side effects in parturients undergoing cesarean section under spinal anesthesia with intrathecal bupivacaine. ⋯ For patients undergoing cesarean section, 10 or 15 μg of intrathecal fentanyl with 10 mg of bupivacaine provided adequate surgical anesthesia and analgesia with minimal side effects.