Articles: operative.
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Background and Objective. Vitamin C has antioxidant, neuroprotective, and neuromodulating effects. Recently, it showed antinociceptive effect as a result of the antioxidant properties. ⋯ Conclusion. This study shows high dose vitamin C infusion decreased postoperative pain during the first 24 h and reduced morphine consumption in the early postoperative period. Additional research needed to examine whether higher doses of vitamin C and longer infusion times can amplify these effects.
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Journal of anesthesia · Dec 2015
Review Meta AnalysisBeta-adrenergic antagonists during general anesthesia reduced postoperative pain: a systematic review and a meta-analysis of randomized controlled trials.
We have performed a systematic literature review and a meta-analysis investigating the effect of beta-adrenergic antagonist on perioperative pain in randomized clinical trials (RCTs). The search included the CENTRAL, CINAHL, EMBASE, and MEDLINE databases (from inception to 10 February 2015). From the retrieved full texts, we hand-searched the references and PubMed related citations. ⋯ However, in two opioid-controlled studies, one in knee arthroscopy and another in tubal ligation patients, the proportion of patients needing rescue analgesia was two-times higher in esmolol-treated patients: 52-57 vs. 23-34%, p < 0.05. Adverse effects were rarely reported, and as reported were mostly cardiovascular alterations. In conclusion, intra-operative beta-adrenergic antagonists' administration may decrease postoperative pain and analgesic consumption when given as an adjuvant to general anesthesia.
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The aim of the present prospective clinical trial was to compare patient-oriented and surgeon-based outcomes after non-operative care with operative treatment of displaced midshaft clavicle fractures. ⋯ Significant superior outcome scores were seen at six weeks for the operative group. However, at 24 weeks and 5-year follow-up no difference was seen in functional outcome scores for both treatment groups. Therefore, the challenge for the future is to better identify the subgroup of patients who might benefit from primary surgical intervention.