Articles: anesthetics.
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J. Cardiothorac. Vasc. Anesth. · Aug 2014
Multicenter Study Comparative Study Clinical TrialProspective, Comparative Study of the On-Q(®) PainBuster(®) Postoperative Pain Relief System and Thoracic Epidural Analgesia After Thoracic Surgery.
Pain after thoracotomy is associated with intense discomfort leading to impaired pulmonary function. ⋯ Sufficient analgesia after thoracotomy can be achieved with the intercostal PainBuster® system in patients, who cannot receive TEA.
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Journal of critical care · Aug 2014
Multicenter StudyEffects of etomidate on vasopressor use in patients with sepsis or severe sepsis: A propensity-matched analysis.
The safety of single-bolus etomidate to facilitate intubation in septic patients is controversial due to its potential to suppress adrenal steroidogenesis. The purpose of this study was to evaluate the effects of etomidate on the development of shock when used as an induction agent to facilitate intubation in septic patients. ⋯ The use of etomidate for intubation in septic patients did not increase vasopressor requirements within 72 hours after intubation.
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Randomized Controlled Trial Multicenter Study Comparative Study
A randomized trial of epidural glucocorticoid injections for spinal stenosis.
Epidural glucocorticoid injections are widely used to treat symptoms of lumbar spinal stenosis, a common cause of pain and disability in older adults. However, rigorous data are lacking regarding the effectiveness and safety of these injections. ⋯ In the treatment of lumbar spinal stenosis, epidural injection of glucocorticoids plus lidocaine offered minimal or no short-term benefit as compared with epidural injection of lidocaine alone. (Funded by the Agency for Healthcare Research and Quality; ClinicalTrials.gov number, NCT01238536.).
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Multicenter Study
Serious complications related to obstetric anesthesia: the serious complication repository project of the society for obstetric anesthesia and perinatology.
Because of the lack of large obstetric anesthesia databases, the incidences of serious complications related to obstetric anesthesia remain unknown. The Society for Obstetric Anesthesia and Perinatology developed the Serious Complication Repository Project to establish the incidence of serious complications related to obstetric anesthesia and to identify risk factors associated with each. ⋯ The Serious Complication Repository Project establishes the incidence of serious complications in obstetric anesthesia. Because serious complications related to obstetric anesthesia are rare, there were too few complications in each category to identify risk factors associated with each. However, because many of these complications can lead to catastrophic outcomes, it is recommended that the anesthesia provider remains vigilant and be prepared to rapidly diagnose and treat any complication.
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Am. J. Respir. Crit. Care Med. · Jun 2014
Multicenter Study Comparative StudyPropofol is Associated with Favorable Outcomes Compared to Benzodiazepines in Ventilated ICU Patients.
Mechanically ventilated intensive care unit (ICU) patients are frequently managed using a continuous-infusion sedative. Although recent guidelines suggest avoiding benzodiazepines for sedation, this class of drugs is still widely used. There are limited data comparing sedative agents in terms of clinical outcomes in an ICU setting. ⋯ In this large, propensity-matched ICU population, patients treated with propofol had a reduced risk of mortality and had both an increased likelihood of earlier ICU discharge and earlier discontinuation of mechanical ventilation.