Articles: anesthetics.
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Ciprofol, a novel intravenous anesthetic, exhibits similar sedation mechanisms and pharmacokinetic properties to propofol. However, ciprofol demonstrates greater potency and is associated with reduced injection pain compared to propofol. Given the varying sensitivities to anesthetic agents across different age groups, this study aims to determine the median effective dose (ED50) of ciprofol required to suppress the laryngeal mask airway (LMA) insertion response in both young and older adult patients, as well as to assess its potential adverse reactions. ⋯ In this study, significant differences were observed in the ED50 of ciprofol for suppressing the LMA insertion response between young and older adult patients. The ED50 of ciprofol for young adult patients was 0.38 mg·kg- 1 (95% CI, 0.35-0.41), while for older adult patients it was0.29 mg·kg- 1 (95% CI, 0.26-0.32).
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Minerva anestesiologica · Dec 2024
A randomized clinical trial comparing different combination of peripheral nerve blocks for intraoperative analgesia in patients on antithrombotic drugs undergoing hip fracture surgery: pericapsular nerve group (PENG) block versus femoral and obturator nerve block.
Locoregional anesthesia is commonly used in orthopedic trauma surgery, particularly in elderly patients. We conducted a prospective, monocentric, randomized controlled trial to evaluate the anesthetic and analgesic efficacy of pericapsular nerve group (PENG) block in patients on antithrombotic drugs undergoing hip fracture surgery, comparing it with femoral and obturator nerve block (FNB+ONB). ⋯ Our results suggest that PENG block is not inferior to FNB + ONB as anesthetic and analgesic technique in patients on antithrombotic drugs undergoing hip fracture surgery.
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Minerva anestesiologica · Dec 2024
New insights into the use of dexamethasone-dexmedetomidine as perineural adjuvants in peripheral nerve and fascial blocks: an up-to-date narrative review.
The discovery of the mechanism of action of local anesthetics, involving the blocking of sodium ion channels is considered a milestone in anesthesia. Potentially lethal toxic effects occur in the case of intravascular injection of local anesthetic (LA) or in case of exceeding dosages, as a result of systemic reabsorption. Attempts to prevent these life-threatening events have been made by developing novel LA and by adding adjuvants. ⋯ The addition of perineural dexamethasone-dexmedetomidine combination has shown a faster onset, longer duration of action and increased intensity of neuronal blockade of regional anesthesia compared to perineural single adjunct. This is consistent with clinical studies (trials, observational studies and reports) of a marked prolongation of the local anesthetic effect. Nevertheless, further studies are needed to ascertain the full potential of this technique and all possible associated risks.
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The aim of this study is to explore the current study status and progression of the effects of ropivacaine in local analgesia by using bibliometric methods. ⋯ The application of ropivacaine to postoperative anesthesia attracts growing interest from the scholars all over the world and was the future research hotspot in treating postoperative pain.
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Randomized Controlled Trial
Bilateral Rectus Sheath Block with Continuous Bupivacaine Infusions After Elective Open Gastrectomy: A Randomized Controlled Trial.
Background and Objectives: Multimodal analgesia has been shown to be effective in facilitating early postoperative gastrointestinal function and rehabilitation in patients undergoing open gastrectomy. We conducted a clinical trial to investigate the effectiveness of bilateral rectus sheath block (RSB) with continuous bupivacaine infusion in comparison with placebo following elective open gastrectomy. Materials and Methods: Patients indicated for elective open gastrectomy were screened, enrolled, and randomised between October 2021 and September 2023. ⋯ Clinically, Group A patients had a significantly shorter time to first gas (p = 0.001), a shorter time to first bowel movement (p < 0.001), a shorter time to first out-of-bed activity (p < 0.001), and a shorter overall hospitalisation duration (p < 0.001) compared to Group B patients. Conclusions: Bilateral RSB with continuous bupivacaine infusion is effective in managing pain and can reduce the use of opioid analgesics in the postoperative period. Furthermore, it promotes early recovery, and a shorter hospital stay.