Abstract：
STUDY OBJECTIVES:To compare the efficacy of diclofenac sodium with ketorolac tromethamine in reducing postoperative morphine use after major orthopedic surgery. DESIGN:Double-blind, randomized, placebo-controlled study. SETTING:Major teaching institution. PATIENTS:102 ASA physical status II patients undergoing hip and knee replacement with general anesthesia. INTERVENTIONS:Before induction of anesthesia, patients were randomly allocated to receive intravenously either diclofenac sodium 75 mg (Group D), ketorolac tromethamine 60 mg (Group K), or placebo (Group P). Patient-controlled analgesia was supplied postoperatively using morphine. MEASUREMENTS:Visual analog scale (VAS), verbal pain score (VPS), sedation score, frequency of opioid side effects, and morphine consumption were recorded every 4 hours. MAIN RESULTS:There was a highly significant downward trend for VAS, VPS, and sedation scores over time, p = 0.001. The mean VAS and VPS scores were significantly lower in Groups D and K compared with Group P at time 0, p = 0.009 and 8 hours, p = 0.026. The mean (SD) 24-hour morphine requirements were 36.3 mg (16.9), 47.2 mg (34.9), and 51.6 mg (22.2) for Groups D, K, and P, respectively, p = 0.032. Fewer patients suffered from postoperative nausea and vomiting in the treatment groups (Groups D and K) compared with Group P (9, 8, and 19, respectively), p < 0.05. Fewer patients also suffered from pruritus in Groups D and K compared with Group P (3, 4, and 11, respectively), p < 0.01. CONCLUSIONS:Preoperative administration of intravenous diclofenac 75 mg or ketorolac 60 mg significantly reduces morphine requirements and associated side effects after major orthopedic surgery.
journal_name
J Clin Anesthjournal_title
Journal of clinical anesthesiaauthors
Alexander R,El-Moalem HE,Gan TJdoi
10.1016/s0952-8180(01)00382-8subject
Has Abstractpub_date
2002-05-01 00:00:00pages
187-92issue
3eissn
0952-8180issn
1873-4529pii
S0952818001003828journal_volume
14pub_type
临床试验,杂志文章,随机对照试验abstract：:Spinal epidural hematoma in the absence of coagulopathy or anticoagulation therapy is an extremely rare occurrence, with a reported incidence of less than 1 in 1 million. We present seven cases of documented epidural hematoma in the absence of coagulopathy or anticoagulation therapy to alert the clinician to consider ...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2003.12.007
更新日期：2004-08-01 00:00:00
abstract：:Transurethral vaporization of the prostate is a new method of electrosurgery used for treating benign prostatic hypertrophy. We observed simultaneous obturator nerve stimulation during spinal anesthesia while the middle lobe of the prostate was being resected. A discussion of why electrovaporization is different from ...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/s0952-8180(98)00069-5
更新日期：1998-09-01 00:00:00
abstract：STUDY OBJECTIVE:The aim of this study was to compare the speed of anesthetic recovery and the perioperative analgesic requirements in patients who received total intravenous anesthesia (TIVA) with either remifentanil-propofol or fentanyl-propofol for lumbar spine surgery. DESIGN:Retrospective cohort study. SETTING:Op...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2015.03.024
更新日期：2015-08-01 00:00:00
abstract：STUDY OBJECTIVES:To evaluate and compare cisatracurium-induced neuromuscular blockade and intubating conditions between immediate postpartum (PP) and nonpregnant (NP) patients. DESIGN:Prospective control study. SETTINGS:University Hospital Center. PATIENTS:44 ASA physical status I and II patients: 22 immediate postp...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章
doi：10.1016/s0952-8180(01)00226-4
更新日期：2001-03-01 00:00:00
abstract：:We report an 11-year-old male with undiagnosed myopathy, who developed cardiac arrest secondary to severe rhabdomyolysis and hyperkalemia following succinylcholine administration. The patient required extracorporeal membrane oxygenation support from which he was eventually weaned successfully. He died eleven days afte...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2003.09.020
更新日期：2004-09-01 00:00:00
abstract：STUDY OBJECTIVE:To compare the efficacy of patient-controlled analgesia (PCA) to physician-controlled analgesia in patients undergoing extracorporeal shock wave lithotripsy (ESWL). DESIGN:Prospective, randomized trial. SETTING:New Jersey Kidney Stone Treatment Center at Robert Wood Johnson University Hospital, New Br...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/0952-8180(95)00008-6
更新日期：1995-05-01 00:00:00
abstract：STUDY OBJECTIVE:To evaluate whether alkalizing local anesthetic with sodium bicarbonate reduces pain related to infiltration of local anesthetic during dorsal penile nerve block for circumcision. DESIGN:Prospective, randomized, double-blind, controlled study. SETTING:E. Wolfson Medical Center, Holon, Israel. PATIENT...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0952-8180(99)00097-5
更新日期：1999-11-01 00:00:00
abstract：STUDY OBJECTIVE:To estimate the optimal endotracheal tube (ETT) length in orotracheally intubated patients. DESIGN:Prospective study. SETTING:Operating room of a medical center hospital. PATIENTS:293 ASA physical status I and II patients (150 male and 143 female), requiring general anesthesia and orotracheal intubat...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/s0952-8180(02)00355-0
更新日期：2002-06-01 00:00:00
abstract：STUDY OBJECTIVE:To test the feasibility and efficacy of a new approach to paravertebral catheter placement in patients undergoing major surgery of the breast. DESIGN:Single-group, single-center observational study. SETTING:Operating room, postoperative recovery area, and normal ward of a university hospital. PATIENT...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2010.12.015
更新日期：2011-09-01 00:00:00
abstract：STUDY OBJECTIVE:To determine if the use of ultrasound guidance (vs non-ultrasound techniques) improves the success rate of nerve blocks. DESIGN:Meta-analysis of randomized controlled trials (RCTs) in the published literature. SETTING:University medical center. MEASUREMENTS:16 RCTs of patients undergoing elective sur...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,meta分析
doi：10.1016/j.jclinane.2010.12.005
更新日期：2011-03-01 00:00:00
abstract：:This study examines whether epidural anesthesia is more effective than general anesthesia using an inhalation agent in controlling cardiovascular responses during femoral-popliteal bypass surgery. Nineteen patients were randomized into two groups: general anesthesia (n = 10) and epidural anesthesia (n = 9). The patien...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/0952-8180(90)90056-9
更新日期：1990-03-01 00:00:00
abstract：:Placement of a central venous catheter into an internal thoracic vein occurs in approximately 2% of all catheterizations. A case in which a pulmonary artery catheter was trapped within the internal thoracic vein during orthotopic heart transplantation is presented. ...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2010.03.010
更新日期：2011-05-01 00:00:00
abstract：STUDY OBJECTIVE:To quantify global coagulation and establish normal ranges for the celite-activated thrombelastograph (TEG) in healthy pediatric patients. DESIGN:Prospective observational study. SETTING:Operating suite of a university-based hospital. PATIENTS:110 healthy pediatric patients in four age groups and 25 ...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章
doi：10.1016/s0952-8180(00)00238-5
更新日期：2001-02-01 00:00:00
abstract：STUDY OBJECTIVE:To evaluate the safety and efficacy of single inferior injection peribulbar block administered by anesthesiologists prior to cataract surgery. DESIGN:Retrospective chart review. SETTING:Freestanding surgery center (teaching). PATIENTS:1,074 consecutive patients who were treated over a two-year period...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章
doi：10.1016/s0952-8180(97)00005-6
更新日期：1997-06-01 00:00:00
abstract：:The case of a patient with hereditary angioedema (HAE), a rare, life-threatening disorder caused by reduced activity of the C1 esterase inhibitor, and requiring off-pump coronary artery bypass graft (OP-CABG) surgery, is presented. Perioperative management of patients with HAE who undergo complex cardiac surgical proc...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2009.04.007
更新日期：2010-06-01 00:00:00
abstract：STUDY OBJECTIVE:To examine contemporary practices and opinions regarding preoperative testing requirements, with special emphasis on perioperative pregnancy recognition and consequences thereof. DESIGN AND SETTING:Anonymous questionnaire survey distributed to 300 (almost exclusively American) physicians attending the ...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/s0952-8180(97)00142-6
更新日期：1997-11-01 00:00:00
abstract：:The perioperative care system is a continuum that includes preoperative patient evaluation, operating room scheduling, the operation itself, and postoperative care. This costly fast-paced system requires its various components to function efficiently and interact effectively. This review explores the interrelation bet...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,评审
doi：10.1016/j.jclinane.2004.10.003
更新日期：2005-06-01 00:00:00
abstract：STUDY OBJECTIVE:To compare the postoperative analgesia of three different concentrations of levobupivacaine for ilioinguinal/iliohypogastric (II/IH) block in children undergoing inguinal hernia repair. DESIGN:Double-blind, prospective, randomized, controlled trial. SETTING:Operating room and postoperative recovery ar...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jclinane.2008.10.012
更新日期：2009-09-01 00:00:00
abstract：STUDY OBJECTIVE:To investigate the influence of duration of deep hypothermic circulatory arrest (DHCA) on recovery of the bispectral index (BIS). DESIGN:Prospective cohort study. SETTING:Operating room of university teaching hospital. PATIENTS:30 adult, ASA physical status III and IV patients scheduled for cardiac s...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2009.09.007
更新日期：2010-08-01 00:00:00
abstract：:Vagus nerve stimulation (VNS) for medically refractory seizures has been an approved therapy by the Food and Drug Administration since 1997, with additional approval as an adjunct therapy for major depression granted in 2005. Potential applications for VNS therapy in obesity, neuropsychiatric disorders, and chronic pa...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,评审
doi：10.1016/j.jclinane.2009.10.002
更新日期：2010-05-01 00:00:00
abstract：STUDY OBJECTIVE:Breast cancer is the most common malignancy of women all over the world. In this study, we compared the effects of ultrasound-guided modified pectoral nerve (PECS) block and erector spinae plane (ESP) block on postoperative opioid consumption, pain scores, and intraoperative fentanyl need of patients un...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jclinane.2018.10.040
更新日期：2019-05-01 00:00:00
abstract：STUDY OBJECTIVES:To evaluate five different preoperative anxiolytic regimens in cataract surgery performed under regional anesthesia; to quantify the pain associated with combined peri- and retrobulbar injection (PRBI) of local anesthetic drugs; and to describe a technique of painless eye block. DESIGN:Randomized, dou...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0952-8180(98)00008-7
更新日期：1998-05-01 00:00:00
abstract：:Inhalatory anesthetic agents are frequently used for anesthesia maintenance. Sevoflurane is considered one of the safest regarding its cardiac effects. We report a case of a cardiac arrhythmia induced by sevoflurane in an otherwise healthy adult and discuss sevoflurane's cardiac effects. ...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2016.06.028
更新日期：2016-11-01 00:00:00
abstract：STUDY OBJECTIVE:To provide a contemporary medicolegal analysis of claims brought against anesthesia providers in the United States related to neuraxial blocks for surgery and obstetrics. DESIGN:In this retrospective analysis, we analyzed closed claims data from the Controlled Risk Insurance Company (CRICO) Comparative...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2019.03.013
更新日期：2019-11-01 00:00:00
abstract：STUDY OBJECTIVE:To evaluate whether children with Down Syndrome are at increased risk of bradycardia and hypotension during and following sevoflurane induction. DESIGN:Retrospective study. SETTING:University-affiliated children's hospital. MEASUREMENTS:The records of children with Down syndrome and a sample matched ...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2010.05.002
更新日期：2010-12-01 00:00:00
abstract：STUDY OBJECTIVE:To evaluate patient acceptability of continued versus divided anesthetic care. DESIGN:Patient satisfaction ratings with continuous and divided anesthetic care were assessed by patient questionnaire. In addition, the effect of training anesthesia personnel in communication regarding divided anesthesia c...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2006.04.004
更新日期：2007-02-01 00:00:00
abstract：STUDY OBJECTIVE:To compare the prophylactic administration of ondansetron with droperidol or placebo to determine its effectiveness in reducing postoperative nausea and vomiting after middle ear procedures. DESIGN:Prospective, randomized, double-blind study. SETTING:Inpatient otolaryngology service at a university me...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0952-8180(97)00099-8
更新日期：1997-09-01 00:00:00
abstract：:Spinal cord injuries continue to be a devastating medical problem. By impairing voluntary and involuntary nervous system function, virtually every body system function is affected. However, pulmonary function alteration and respiratory complications continue to be the major causes of morbidity and mortality in patient...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/s0952-8180(03)00105-3
更新日期：2003-08-01 00:00:00
abstract：STUDY OBJECTIVE:To evaluate the efficacy and safety profile of paracetamol in comparison with tramadol for pain relief during active labor. DESIGN:Prospective, randomized, double-blind study. SETTING:Maternity Wing of the Postgraduate Institute of Medical Education and Research, Chandigarh. PATIENT:Sixty laboring, p...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jclinane.2014.08.008
更新日期：2015-03-01 00:00:00
abstract：:In December 2001, the United States Food and Drug Administration (FDA) added a "black box" warning to the labeling for droperidol stating that all doses, even those typically used for postoperative nausea and vomiting, were potentially associated with malignant ventricular dysrhythmias, including torsade de pointes. T...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/s0952-8180(02)00445-2
更新日期：2002-12-01 00:00:00
