Articles: patients.
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Journal of anesthesia · Jan 2000
Continuous intra-arterial blood gas monitoring during thoracic surgery.
This study was undertaken to assess the clinical usefulness of a continuous intra-arterial blood gas (CIABG) monitoring system, Paratrend 7, during thoracic surgery. ⋯ The agreement between CIABG and ABG measurements was better for PCO(2) and pH than for PO(2). The PO(2) value displayed on the CIABG monitor may not always be reliable during thoracic surgical procedures.
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Internal jugular vein cannulation has become a routinary and clinically important aspect of medical care in critically ill patients. The landmark-guided technique usually affords rapid and easy vascular access, but it is not always successful and may be complicated by arterial puncture, hematoma, pneumothorax. A prospective, descriptive study is reported on the use and success of ultrasound-assisted central vein catheterization in dialysis patients who had an indication for internal jugular vein catheterization. ⋯ In all cases, the left internal jugular vein could be cannulated without difficulties. Our results confirm that ultrasound-guided cannulation of the internal jugular vein offers several advantages over the external landmarks technique: higher success rate in both vein puncture and catheter placement, lower complications, lower patient discomfort during the procedure because of a low number of needle passes. Ultrasound-assisted cannulation of the internal jugular vein may become the standard approach to dialysis catheter placement in the future.
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The purpose of this research trial is to assess the effectiveness and tolerability of tizanidine in neuropathic pain. In an open-label study, patients with neuropathic pain received 1 to 4 mg of tizanidine once daily for 7 days, followed by weekly dose escalation of 2 to 8 mg to his/her effective or maximum tolerated dose or a maximum of 36 mg over an 8-week period. Treatment effects were assessed, using average weekly pain scores as well as biweekly scores for patient global assessment of pain relief, the neuropathic pain scale, and wisconsin brief pain inventory. ⋯ Tizanidine might be an effective treatment for neuropathic pain, offering an alternative for patients poorly responsive to other medications. A larger, randomized placebo-controlled trial is recommended. In addition, comparative studies with alternative agents should be sought.
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The practice guidelines for interventional techniques in the management of chronic pain are systematically developed statements to assist practitioner and patient decisions about appropriate health care related to chronic pain. These guidelines are professionally derived recommendations for practices in the diagnosis and treatment of chronic or persistent pain. ⋯ Included in the guidelines is a discussion of their purpose,rationale, importance, and methodology, and patient population, pathophysiologic basis, and various interventional techniques utilized in the management of chronic pain including rationale, outcomes, and cost effectiveness. They also describe the role of diagnostic blocks and therapeutic blocks with suggested algorithms for interventional techniques in the management of conservative care of chronic pain.