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Items 1 - 17 of 17 |
One page. |
Inhibition of hiccups by the laryngeal mask airway.
Baraka A.
Publication Types:
PMID: 15310374 [PubMed - indexed for MEDLINE]
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Well-fitting dentures -- friend or foe?
Shah T, Jones N.
Publication Types:
PMID: 15310366 [PubMed - indexed for MEDLINE]
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The effect of celecoxib on intrathecal morphine-induced pruritus in patients undergoing Caesarean section.
Lee LH, Irwin MG, Lim J, Wong CK.
Department of Anaesthesiology, Universiy of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong. libbylee@hkucc.hku.hk
Pruritus associated with intrathecal opioid administration is particularly common in pregnancy. Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce the severity of this pruritus but have undesirable side effects. The recent development of drugs that can specifically inhibit the cyclooxygenase 2 isoenzyme have become an attractive alternative. This study was designed to evaluate the efficacy of such a drug (celecoxib) in reducing intrathecal opioid-induced pruritus in a randomised double-blinded study of 60 women undergoing Caesarean section. All of them received spinal anaesthesia with 3 ml of 0.5% hyperbaric bupivacaine and 0.3 mg preservative-free morphine. After delivery of the baby, they received either oral celecoxib 200 mg or placebo. Visual analogue scores for pain and pruritus were measured at 30 min, 2, 4, 8, and 24 h. There was no difference in the severity and onset of pain and pruritus between the two groups. Timing of administration, inadequate dosing and possible altered pharmacokinetics in pregnancy may explain the lack of efficacy.
Publication Types:
- Clinical Trial
- Randomized Controlled Trial
PMID: 15310350 [PubMed - indexed for MEDLINE]
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A partially blinded randomised controlled trial of patient-maintained propofol sedation and operator controlled midazolam sedation in third molar extractions.
Leitch JA, Anderson K, Gambhir S, Millar K, Robb ND, McHugh S, Kenny GN.
University of Glasgow Dental School, 378 Sauchiehall Street, Glasgow, G2 3JZ, UK. leitch@bigfoot.com
Patient-maintained sedation using propofol has recently been shown to be effective for dental surgery. We compared this new technique to the established technique of operator administered midazolam. The two groups were compared before, during and after sedation. The two primary outcomes were time until discharge and oxygen saturation. Vital signs, anxiety and psychomotor skills were also compared. State anxiety was reduced to a greater extent in the propofol group (mean difference 10 (SD 4) mm; p = 0.010. Propofol patients recovered quicker (mean difference 7 (SD 1.4) min; p = 0.001). Propofol patients had a smaller reduction in arterial oxygen saturation (mean difference 0.8 (SD 0.3)%; p = 0.030), and a reduced increase in heart rate (mean difference 9 (SD 2) beats.min(-1); p < 0.001). Both techniques were well tolerated and safe. Propofol sedation offered superior anxiolysis, quicker recovery, less amnesia and less depression of simple psychomotor function.
Publication Types:
- Clinical Trial
- Randomized Controlled Trial
PMID: 15310346 [PubMed - indexed for MEDLINE]
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A randomised controlled trial of paediatric conscious sedation for dental treatment using intravenous midazolam combined with inhaled nitrous oxide or nitrous oxide/sevoflurane.
Averley PA, Girdler NM, Bond S, Steen N, Steele J.
Principle Dentist, Queensway Anxiety Management Clinic, 170 Queensway, Billingham, UK. paul@averley.com
Failure of dental treatment due to anxiety is a common problem in children. The aim of this study was to establish whether the use of a combination of intravenous midazolam with inhalation agents (nitrous oxide alone or in combination with sevoflurane) was any more likely to result in successful completion of treatment than midazolam alone. A further aim was to evaluate the clinical viability of these techniques as an alternative to general anaesthesia. In total, 697 children too anxious for management with relative analgesia and requiring invasive dental procedure for which a general anaesthetic would usually be required, were recruited and randomly assigned to one of three groups given the following interventions: group 1 - a combination of inhaled medical air and titrated intravenous midazolam, group 2 - a combination of inhaled 40% nitrous oxide in oxygen and titrated intravenous midazolam, and group 3 - a combination of an inhaled mixture of sevoflurane 0.3% and nitrous oxide 40% in oxygen with titrated intravenous midazolam. The primary outcome measure was successful completion of the intended dental treatment with a co-operative child responsive to verbal commands. In group 1, 54% (94/174 children) successfully completed treatment. In group 2, 80% (204/256 children) and in group 3, 93% (249/267 children) completed treatment. This difference was significant at the 1% level. Intravenous midazolam, especially in combination with inhaled nitrous oxide or sevoflurane and nitrous oxide, are effective techniques, with the combination of midazolam and sevoflurane the one most likely to result in successful treatment.
Publication Types:
- Clinical Trial
- Randomized Controlled Trial
PMID: 15310345 [PubMed - indexed for MEDLINE]
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Fire hazards with ambulatory anesthesia in the dental office.
Weaver JM.
Publication Types:
PMID: 15366316 [PubMed - in process]
 
Comparative effect of intraoperative propacetamol versus placebo on morphine consumption after elective reduction mammoplasty under remifentanil-based anesthesia: a randomized control trial [ISRCTN71723173].
Binhas M, Decailliot F, Rezaiguia-Delclaux S, Suen P, Dumerat M, Francois V, Combes X, Duvaldestin P.
Service d'Anesthesie-Reanimation, Hopital Henri Mondor, AP-HP, Universite Paris XII, 51, avenue du Marechal de Lattre de Tassigny, 94010 Creteil, France. michele.binhas@hmn.ap-hop-paris.fr
BACKGROUND: Postoperative administration of paracetamol or its prodrug propacetamol has been shown to decrease pain with a morphine sparing effect. However, the effect of propacetamol administered intra-operatively on post-operative pain and early postoperative morphine consumption has not been clearly evaluated. In order to evaluate the effectiveness of analgesic protocols in the management of post-operative pain, a standardized anesthesia protocol without long-acting opioids is crucial. Thus, for ethical reasons, the surgical procedure under general anesthesia with remifentanil as the only intraoperative analgesic must be associated with a moderate predictable postoperative pain. METHODS: We were interested in determining the postoperative effect of propacetamol administered intraoperatively after intraoperative remifentanil. Thirty-six adult women undergoing mammoplasty with remifentanil-based anesthesia were randomly assigned to receive propacetamol 2 g or placebo one hour before the end of surgery. After remifentanil interruption and tracheal extubation in recovery room, pain was assessed and intravenous titrated morphine was given. The primary end-point was the cumulative dose of morphine administered in the recovery room. The secondary end-points were the pain score after tracheal extubation and one hour after, the delay for obtaining a Simplified Numerical Pain Scale (SNPS) less than 4, and the incidence of morphine side effects in the recovery room.For intergroup comparisons, categorical variables were compared using the chi-squared test and continuous variables were compared using the Student t test or Mann-Whitney U test, as appropriate. A p value less than 0.05 was considered as significant. RESULTS: In recovery room, morphine consumption was lower in the propacetamol group than in the placebo group (p = 0.01). Pain scores were similar in both groups after tracheal extubation and lower in the propacetamol group (p = 0.003) one hour after tracheal extubation. The time to reach a SNPS < 4 was significantly shorter in the propacetamol group (p = 0.02). The incidence of morphine related side effects did not differ between the two groups. CONCLUSIONS: Intraoperative propacetamol administration with remifentanil based-anesthesia improved significantly early postoperative pain by sparing morphine and shortening the delay to achieve pain relief.
PMID: 15367329 [PubMed - as supplied by publisher]
Proceedings of the 6th International Symposium of Memory and Awareness in Anaesthesia and Intensive Care. June 2-4, 2004, University of Hull, United Kingdom.
[No authors listed]
Publication Types:
PMID: 15372729 [PubMed - indexed for MEDLINE]
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Articaine for sub-Tenon's and peribulbar anaesthesia in cataract surgery.
King TA, Mitchell J, Altman K, Ozdemir M, Allman KG.
Eastbourne, UK.
PMID: 15361476 [PubMed - in process]
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Editorial III: Anaphylaxis and anaesthesia--all clear now?
Axon AD, Hunter JM.
Department of Anaesthesia, University of Liverpool, University Clinical Department, Duncan Building, Daulby Street, Liverpool L69 3GA, UK.
PMID: 15361475 [PubMed - in process]
Blood flow-dependent changes in intrarenal nitric oxide levels during anesthesia with halothane or sevoflurane.
Kusudo K, Ishii K, Rahman M, Aki Y, Miyatake A, Kosaka H, Kimura S, Komatsu T, Yokoyama M, Morita K, Abe Y, Nishiyama A.
Department of Anesthesiology, Mitoyo General Hospital, Kagawa 769-1695, Japan.
We previously demonstrated that intrarenal nitric oxide (NO) levels and renal blood flow are reduced during halothane anesthesia. Studies were performed to determine if volatile anesthetics-induced reductions in renal NO levels are associated with blood flow changes. Halothane and sevoflurane at 0.8 and 2.4 Mac were administered by inhalation to dogs, and cGMP and NOx concentrations in the renal interstitial fluid were measured by a microdialysis method. Neither halothane nor sevoflurane at 0.8 Mac altered renal blood flow and renal interstitial cyclic guanosine monophosphate (cGMP) and NOx levels, but both anesthetics significantly decreased these values at 2.4 Mac. Using an adjustable aortic clamp, renal perfusion pressure was reduced in 2 steps without halothane and sevoflurane anesthesia. Renal blood flow as well as cGMP and NOx concentrations in the renal interstitial fluid were unchanged within the autoregulatory range, but significantly decreased below the autoregulatory range. Changes in cGMP and NOx concentrations in the renal interstitial fluid were highly correlated with renal blood flow changes during halothane or sevoflurane anesthesia, and during stepwise reductions in renal perfusion pressure. The results suggested that halothane- and sevoflurane-induced decreases in intrarenal NO levels result from reductions in blood flow.
PMID: 15364004 [PubMed - in process]
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CME in cardiothoracic and vascular anesthesia.
[No authors listed]
PMID: 15365949 [PubMed - as supplied by publisher]
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Con: Cardiothoracic anesthesiologists should not run postcardiac surgical intensive care units.
Ramsay J.
PMID: 15365940 [PubMed - in process]
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Pro: Cardiothoracic anesthesiologists should run postcardiac surgical intensive care units.
Weiss SJ.
PMID: 15365939 [PubMed - in process]
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Thoracic epidural local anesthetics are ineffective in alleviating post-thoracotomy ipsilateral shoulder pain.
Barak M, Ziser A, Katz Y.
Objective: This study was conducted to estimate the incidence and clinical predictors of post-thoracotomy shoulder pain and to determine the effectiveness of thoracic epidural block in alleviating this pain. Design: A prospective clinical trial. Setting: University teaching hospital. Participants and Interventions: Thirty-two adult patients undergoing elective thoracic surgery consented to participate in the study. All operations were open thoracotomies done by the same team of surgeons and anesthesiologists. A thoracic (T6) epidural catheter was placed before induction of general anesthesia. Each patient received 7 mL of lidocaine 2% epidurally and repeated doses of 5 mL of lidocaine 2% every half hour during the operation. Postoperatively, the occurrence of incision or ipsilateral shoulder pain was observed and treated with a maximal dose of 5 mL of lidocaine 2%. If ineffective, indomethacin suppository (nonsteroidal anti-inflammatory drug [NSAID]) was given. Variables such as patient's age, sex, American Society of Anesthesiologists physical status, type, site and duration of surgery, duration of anesthesia, the resection of main bronchus, and the use of thoracostomy tubes were recorded. Measurements and Main Results: Postoperatively, 10 patients (31%) had shoulder pain, 4 patients (12.5%) complained of incision pain, and 2 (6.3%) complained of both incision and shoulder pain. A bolus of 5 mL of lidocaine 2% in the epidural catheter relieved incision pain in all the patients, but was ineffective for shoulder pain. Indomethacin suppository was effective in these patients. No correlation was found between any variable and the occurrence of shoulder pain. Conclusions: It is concluded that post-thoracotomy shoulder pain is a common problem, and the previously mentioned variables did not predict its appearance. Thoracic epidural block is effective in the treatment of incision but not shoulder pain. The NSAID indomethacin suppository was found to be effective for that problem.
PMID: 15365928 [PubMed - in process]
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Gaston Labat and John Lundy: friends and pioneer regional anesthesiologists sharing a Mayo clinic connection.
Pulido JN, Bacon DR, Rettke SR.
Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
PMID: 15372395 [PubMed - in process]
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Hearing loss does not occur in young patients undergoing spinal anesthesia.
Ok G, Tok D, Erbuyun K, Aslan A, Tekin I.
Department of Anesthesiology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey. gulayok@hotmail.com
BACKGROUND AND OBJECTIVES: Although uncommon, hearing loss after spinal anesthesia has been described. Vestibulocochlear dysfunction after spinal anesthesia in which 22-gauge and 25-gauge Quincke needles were used was investigated to determine if needle size affected hearing. METHODS: Patients with American Society of Anesthesiologists physical status I and II, aged 20 to 40 years, who were undergoing lower extremity surgery under spinal anesthesia were randomized into 2 groups. After intravenous hydration, 3 mL of 0.5% bupivacaine was administered for spinal anesthesia, which was performed with a 22-gauge Quincke needle in group I (n=30) patients and a 25-gauge Quincke needle in group II (n=30) patients. Before surgery and 2 days after surgery, pure-tone audiometry and tympanometry were performed. Preoperative and postoperative hearing data were obtained in the right and left ears for every frequency. Headache, nausea, and vomiting and cranial nerve III, IV, V, VI, VII, and VIII function were assessed on postoperative day 2. RESULTS: Demographic data were not different between the groups. No hypoacousis was noted at any frequency during the entire testing period in either group. Two patients from group I experienced postdural puncture headache on postoperative day 3, and neither had hearing loss. No patient had cranial nerve dysfunction. CONCLUSIONS: We were unable to induce hearing loss in young patients undergoing spinal anesthesia by injecting the anesthetic with a 22-gauge or a 25-gauge Quincke needle.
PMID: 15372387 [PubMed - in process]
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