Articles: postoperative.
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Curr Opin Anaesthesiol · Oct 2003
Peripheral nerve blocks for anaesthesia and postoperative analgesia.
Perioperative analgesia is a major concern for the patient and for the anesthesiologist, whose task is to avoid pain and all related complications on immediate outcome and healing. Regional anesthesia, alone or combined with general anesthesia, is becoming a preferred technique in a variety of surgical procedures. There is increasing interest in peripheral nerve blocks, single or continuous, mainly for perioperative treatment of unilateral surgery. Specificity of analgesic area combined with decreased complications, including spinal or epidural hematoma, urinary retention, or hemodynamic alterations, are advantages of the peripheral nerve block over more central neural blocks. ⋯ Possibilities afforded by the use of peripheral nerve blocks mainly consist of prolonged analgesia, selective area of action, and fewer collateral effects when compared with general anesthesia or more central neural blockade. Introduction of new devices and new techniques are increasing, as evidenced by the large number of studies which have appeared in the literature during the past year.
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The purpose of this review is to present recent research into the clinical use of regional anaesthesia techniques in ambulatory surgery. Further, to put into an ambulatory perspective some of the issues recently discussed on the basis and practice of regional anaesthesia in general. ⋯ Loco-regional techniques are well suited for ambulatory surgery due to less postoperative nausea and pain and possibly less cognitive dysfunction. The different techniques are continuously being refined in order to provide fast discharge readiness, while still maintaining the benefits.
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Curr Opin Anaesthesiol · Oct 2003
Epidural anaesthesia and analgesia for surgery: still going strong?
The discussion on the value of epidural anaesthesia and analgesia for surgery is fuelled by current controversies regarding effects on postoperative morbidity and mortality, potential benefits for outcome and the fear of rare, but catastrophic neurological complications. This review of the most recent publications on the topic since April 2002 illustrates some of the aspects contributing to the ongoing discussion. ⋯ In an era of evidence-based medicine, further meta-analyses and well-planned large randomized trials have to address the controversial issues of epidural anaesthesia and analgesia and postoperative outcome. In the context of a more holistic 'rehabilitative' management of the perioperative period, this technique might well represent a key factor to improve outcome, reduce hospital stay and thereby healthcare costs. Recent innovations and developments in techniques and drugs as well as established guidelines should further minimize potential errors and harmful complications.
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Naproxen and naproxen sodium are non-steroidal anti-inflammatory drugs used in a variety of painful conditions, including the treatment of postoperative pain. This review aims to assess the efficacy, safety and duration of action of a single oral dose of naproxen/naproxen sodium for moderate to severe acute postoperative pain in adults, compared with placebo. ⋯ A single oral dose of naproxen sodium 550 mg is an effective analgesic in the treatment of acute postoperative pain. A low incidence of adverse events was found, although these were not reported consistently.
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Rev Bras Anestesiol · Sep 2003
Analgesia and sedation with epidural clonidine associated to 0.75% ropivacaine in the postoperative period of open cholecystectomy.
Epidural clonidine has analgesic properties and potentiates local anesthetic effects; there are, however, some side effects including: arterial hypotension, bradycardia and sedation. This study aimed at evaluating analgesia and sedation of clonidine associated to 0.75% ropivacaine in the postoperative period of open cholecystectomy. ⋯ The association of clonidine and ropivacaine has produced longer analgesia and sedation at 2 and 6 hours of observation.