Anesthesiology and pain medicine
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Postoperative pain control (especially, after adenotonsillectomy) has a very important effect on recovery time, hospitalization duration, hemodynamic disorders, bleeding, nausea, vomiting and medical costs. ⋯ Post-operative pain in rectal acetaminophen group was less than that in intravenous acetaminophen group, and rectal acetaminophen group demanded their first additional analgesic medication later.
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In the present review, the analgesic effects of lidocaine in acute or chronic painful conditions in the emergency department are discussed. Lidocaine, as a medium-acting local anesthetic with short onset time, is well-recognized, not only as a valuable medication for numerous neuropathic pain conditions, but also for the management of both acute and chronic pain. ⋯ The antinociceptive properties of lidocaine are derived from multifaceted mechanisms, turning it into a medication that is safe to administer via different routes which makes it available for use in a variety of medical conditions.
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Laryngospasm is the protective reflex of tracheobronchial tree against secretions and hemorrhage. This reflex is more prevalent in adenotonsillectomy in the presence of light anesthesia, which can lead to obstruction of airway, complications, and mortality. Different methods have been studied for preventing this complication; however, none of them could reliably prevent it. ⋯ Intravenous magnesium sulfate with dose of 15 mg/kg could not prevent laryngospasm and coughing after removal of the endotracheal tube in patients undergoing adenotonsillectomy; however, it reduced coughing and laryngospasm in the magnesium sulfate group compared with the control group.
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Hemodynamic stability and blood loss reduction are subjects to further consideration in patients undergoing percutaneous nephrolithotomy (PNCL). ⋯ It seems that, in patients undergoing PNCL, SA is as effective and safe as GA. Patients who undergo PNCL under SA require smaller amounts of analgesic dose and show hemodynamic stability during surgery and recovery time. Also, SA technique provides decreased blood loss and shortened surgery as well as anesthesia times compared to GA.