Articles: postoperative.
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The use of lung-protective ventilation (LPV) strategies may minimize iatrogenic lung injury in surgical patients. However, the identification of an ideal LPV strategy, particularly during one-lung ventilation (OLV), remains elusive. This study examines the role of ventilator management during OLV and its impact on clinical outcomes. ⋯ Low VT per se (i.e., in the absence of sufficient PEEP) has not been unambiguously demonstrated to be beneficial. The authors found that a large proportion of patients continue to receive high VT during OLV and that VT was inversely related to the incidence of respiratory complications and major postoperative morbidity. While low (physiologically appropriate) VT is an important component of an LPV strategy for surgical patients during OLV, current evidence suggests that, without adequate PEEP, low VT does not prevent postoperative respiratory complications. Thus, use of physiologic VT may represent a necessary, but not independently sufficient, component of LPV.
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Acta Anaesthesiol Taiwan · Jun 2016
CommentMagnesium sulfate for postoperative analgesia after surgery under spinal anesthesia.
Magnesium has been proven to have antinociceptive effects in animal and human models of pain. Its effect is primarily based on the regulation of calcium influx into the cell, which is natural physiological calcium antagonism and N-methyl-d-aspartate (NMDA) receptor antagonism. ⋯ Intravenous magnesium sulfate when given as a bolus, followed by an infusion, delayed and decreased the need of rescue analgesics after spinal anesthesia.
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Randomized Controlled Trial
Intraperitoneal ketorolac for post-cholecystectomy pain: a double-blind randomized-controlled trial.
Ketorolac is a parenterally active nonsteroidal anti-inflammatory drug with localized anti-inflammatory properties. We examine the postoperative analgesic efficacy of locally administered intraperitoneal (IP) ketorolac compared with intravenous (IV) ketorolac during laparoscopic cholecystectomy. ⋯ This study did not demonstrate any advantage for the off-label topical intraperitoneal administration of ketorolac in this surgical population. Intraperitoneal and IV ketorolac showed comparable analgesic efficacy following laparoscopic cholecystectomy.