Abstract:
STUDY OBJECTIVE:To evaluate the consequences of opioid use for postoperative pain management and the degree to which these consequences may be reduced or minimized with opioid-sparing or opioid-replacement techniques. DESIGN:Literature review relating to the economics of postoperative pain management. Comparisons between opioids and opioid-sparing techniques were identified and selected for study. MEASUREMENTS AND MAIN RESULTS:Studies evaluating overall economic impacts or surrogate outcomes (e.g., resource use or recovery milestones) showed benefits with opioid-sparing therapies. CONCLUSIONS:Opioids will likely remain an integral part of postoperative pain management, but side effects increase the costs of care. The challenge is to identify situations where opioid-sparing techniques improve surrogate economic measurements and decrease overall hospital costs.
journal_name
J Clin Anesthjournal_title
Journal of clinical anesthesiaauthors
Philip BK,Reese PR,Burch SPdoi
10.1016/s0952-8180(02)00372-0subject
Has Abstractpub_date
2002-08-01 00:00:00pages
354-64issue
5eissn
0952-8180issn
1873-4529pii
S0952818002003720journal_volume
14pub_type
杂志文章,评审abstract::We present a case in which an anemic patient with religious objections to blood transfusion experienced three episodes of severe myocardial ischemia during the perioperative period. The first episode of ischemia was successfully treated by discontinuing isoflurane and resolving the hypotension. The second and third ep...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(96)00086-4
更新日期:1996-08-01 00:00:00
abstract:BACKGROUND:Childhood and adolescent obesity increased in recent decades, and caregivers face an increasing number of obese pediatric surgical patients. Some clinical and pharmacogenetic data suggest that obese patients have altered pain sensitivity and analgesic requirements. OBJECTIVE:To test the primary hypothesis t...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2020.109729
更新日期:2020-06-01 00:00:00
abstract::This is a case of systemic ropivacaine toxicity from a sciatic nerve catheter. A 20-year-old patient after heart transplant with poor systemic perfusion on hemodialysis and multiple medications experienced local anesthetic systemic toxicity 72 hours after placement of a peripheral nerve catheter. The case demonstrates...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2015.03.021
更新日期:2015-06-01 00:00:00
abstract:STUDY OBJECTIVE:To determine if intrathecal opioid decreases time to extubation after coronary artery bypass surgery without compromising postoperative analgesia. DESIGN:Prospective randomized trial. SETTING:Veterans Affairs Hospital. PATIENTS:21 ASA physical status III and IV men scheduled for elective coronary byp...
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)00081-0
更新日期:1997-08-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the postoperative analgesic efficacy of, and the effects on, intraoperative inhalational anesthetic requirements of preincisional caudal epidural block versus postincisional infiltration of local anesthetic following umbilical herniorrhaphy in children. DESIGN:Randomized, double-blind, pro...
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(96)00171-7
更新日期:1996-12-01 00:00:00
abstract:PURPOSE:The aim of this study was to evaluate the effect of neuraxial blocks on surgical blood losses and on the number of patients requiring blood transfusion. METHODS:A search of the American National Library of Medicine's PubMed up to November 12, 2004, was performed. Twenty-four studies could be kept for analysis....
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,meta分析
doi:10.1016/j.jclinane.2005.08.013
更新日期:2006-03-01 00:00:00
abstract::Multiple drugs are used to provide anesthesia. Volatile anesthetics are commonly combined with opioids. Several studies have demonstrated that small doses of opioid (i.e., within the analgesic range) result in a marked reduction in minimum alveolar concentration (MAC) of the volatile anesthetic that will prevent purpo...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,评审
doi:10.1016/s0952-8180(97)00122-0
更新日期:1997-09-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the cardiovascular changes following induction of anesthesia, laryngoscopy, and intubation in patients receiving a bolus dose of either eltanolone or propofol. DESIGN:Randomized, controlled, blind, prospective clinical study. SETTING:General operating theaters of a university hospital. PA...
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(94)00026-z
更新日期:1995-03-01 00:00:00
abstract:STUDY OBJECTIVE:To investigate associations of heart rate variability (HRV) measurements with postoperative atrial fibrillation (AF) in patients undergoing off-pump coronary surgery. DESIGN:Prospective, observational, exploratory study. SETTING:Large university-affiliated community medical center. PATIENTS:50 patien...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2010.12.016
更新日期:2011-09-01 00:00:00
abstract::Neuroleptic malignant syndrome is an uncommon, idiosyncratic, and sometimes life-threatening disorder associated with the use of neuroleptic drugs. The pathogenesis of neuroleptic malignant syndrome is uncertain, but it may be similar to that of malignant hyperthermia (MH). Some of the symptoms of neuroleptic malignan...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(90)90096-l
更新日期:1990-05-01 00:00:00
abstract:STUDY OBJECTIVE:To compare a total intravenous (IV) anesthetic technique based on propofol and alfentanil with a commonly used anesthetic technique for craniotomy. DESIGN:Open-label, randomized, clinical study. SETTING:Neurosurgical clinic at a university hospital. PATIENTS:Forty patients, aged 18 to 55 years, sched...
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(91)90010-k
更新日期:1991-03-01 00:00:00
abstract::Brugada syndrome is an electrical cardiac disease predisposing to ventricular arrhythmias in which typical electrocardiographic (ECG) features consist of nonischemic repolarization abnormalities in the right precordial leads V1-V3. The appearance of a Brugada-ECG pattern is increasingly observed in critically ill pati...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2013.02.012
更新日期:2013-09-01 00:00:00
abstract:STUDY OBJECTIVE:The aim of this study is to compare the effects of intravenous single-dose dexketoprofen trometamol and diclofenac sodium 30 minutes before the end of the surgery on relief of postoperative pain in patients undergoing laparoscopic cholecystectomy. DESIGN:A randomized fashion. SETTING AND PATIENTS:Sixt...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2016.02.020
更新日期:2016-08-01 00:00:00
abstract::A case of unusual triple knotting of a central venous catheter inserted through the left basilic vein is reported. The catheter with intact triple knots could be withdrawn without an invasive maneuver. A possible cause of triple knotting was discussed in regard to the anatomic configuration of the central veins. This ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(89)90045-7
更新日期:1989-01-01 00:00:00
abstract:STUDY OBJECTIVE:To determine whether a new Sonoclot-based, aprotinin-insensitive activated clotting time (aiACT) assay yields stable results over a broad range of aprotinin concentrations. DESIGN:Prospective trial conducted on in vitro blood samples. SETTING:Tertiary-care teaching medical center. PARTICIPANTS:19 hea...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2007.03.003
更新日期:2007-09-01 00:00:00
abstract:STUDY OBJECTIVE:To assess bispectral index (BIS) monitoring on decision making during cardiac surgery with cardiopulmonary bypass (CPB) by measuring the number of preset standardized comments with and without knowing the BIS value and by classifying the interventions following the BIS data. DESIGN:Prospective, randomi...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2004.12.018
更新日期:2005-11-01 00:00:00
abstract:STUDY OBJECTIVE:To examine postoperative sore throat resulting from tracheal intubation stylet removal. DESIGN:Prospective cohort study. SETTING:Operating rooms and hospital ward. PATIENTS:A total of 50 American Society of Anesthesiologists physical status 1 and 2 patients who underwent elective abdominal and/or ort...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2015.12.024
更新日期:2016-09-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the influence of temperature and duration of cardiopulmonary bypass (CPB) on blood loss and transfusion requirements. DESIGN:Retrospective chart review. SETTING:Tertiary care, academic medical institution. MEASUREMENTS AND MAIN RESULTS:The charts of 378 patients who had undergone primary...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(98)00085-3
更新日期:1998-11-01 00:00:00
abstract::Quadriparesis is a potentially catastrophic complication during operative procedures. It may result from a number of different types of central nervous system insults. A case of quadriparesis following an otherwise unremarkable percutaneous nephrolithotomy surgery is reported. The quadriparesis resulted from multiple ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2014.01.007
更新日期:2014-06-01 00:00:00
abstract::Informed consent is a cornerstone and routine component of the ethical practice of modern medicine. Its full theoretical application to specific clinical situations, however, presents a number of ethical dilemmas for health care providers. Obstetric anesthesia, in particular, presents many unique challenges to the pro...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,评审
doi:10.1016/s0952-8180(02)00505-6
更新日期:2003-12-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the effects of respiratory acidosis and alkalosis by mechanical ventilation on the onset, duration, and recovery times of vecuronium. DESIGN:Randomized, prospective study. SETTING:Operating rooms in the Sapporo Medical University Hospital and Kitami Red Cross Hospital. PATIENTS:90 ASA ph...
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(01)00361-0
更新日期:2002-03-01 00:00:00
abstract::With the advent of safety needles to prevent inadvertent needle sticks in the operating room (OR), a potentially new issue has arisen. These needles may result in coring, or the shaving off of fragments of the rubber stopper, when the needle is pierced through the rubber stopper of the medication vial. These fragments...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2013.10.007
更新日期:2014-03-01 00:00:00
abstract::We present a case of successful epidural analgesia/anesthesia for labor and cesarean section in a parturient who developed pseudotumor cerebri during her pregnancy and was managed with lumboperitoneal shunt secondary to her visual complication. ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(00)00133-1
更新日期:2000-05-01 00:00:00
abstract:STUDY OBJECTIVE:To test the hypothesis that emotional intelligence, as measured by the Bar-On Emotional Quotient Inventory (EQ-I) 125 (Multi Health Systems, Toronto, Ontario, Canada) personal inventory, would correlate with resident performance. DESIGN:Prospective survey. SETTING:University-affiliated, multiinstituti...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2007.12.008
更新日期:2008-03-01 00:00:00
abstract:STUDY OBJECTIVE:Preoperative anxiety is commonly reported by people undergoing surgery. A significant number of studies have found a correlation between preoperative anxiety and post-operative morbidity. Various methods of complementary and alternative medicine (CAM) were found to be effective in alleviating preoperati...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2015.10.017
更新日期:2016-03-01 00:00:00
abstract::We report the use of high-frequency oscillatory ventilation in the operating room during repair of multiple bronchopleural fistulae in a 9-year-old boy. In addition, we used principles of permissive hypercapnia to further minimize barotrauma. There were no cardiovascular consequences due to either the high-frequency v...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/S0952-8180(96)00206-1
更新日期:1997-02-01 00:00:00
abstract:STUDY OBJECTIVE:To establish the analgesic effective doses as defined as a visual analog pain scale (VAS) of at least 10 for 95% of parturients (ED95) receiving either epidural fentanyl or sufentanil with bupivacaine 0.125% for labor analgesia. DESIGN:Double-blind, randomized controlled study. SETTING:Two tertiary-ca...
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)00113-5
更新日期:1998-12-01 00:00:00
abstract::Over a 12-month period, 1,743 patients were retrospectively evaluated for anaphylactic/anaphylactoid reactions during cardiac surgery. Reactions to protamine, vancomycin, blood, and metocurine were observed in eight patients (0.46%). Baseline to reaction mean arterial pressures decreased from 81 +/- 9 mmHg to 50 +/- 7...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(89)90005-6
更新日期:1989-01-01 00:00:00
abstract:STUDY OBJECTIVE:To compare analgesia and opioid-related side effects of intrathecal morphine and intrathecal hydromorphone after elective Cesarean delivery. DESIGN:Retrospective, comparative study. SETTING:Labor and delivery unit of an academic hospital. PATIENTS:114 parturients age ≥ 18 years, presenting for electi...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2013.01.014
更新日期:2013-08-01 00:00:00
abstract:STUDY OBJECTIVE:Several factors such as lack of unidirectional, turbulent free laminar airflow, duration of surgery, patient warming system, or the number of health professionals in the OR have been shown or suspected to increase the number of airborne bacteria. The objective of this study was to perform a multivariate...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2017.02.008
更新日期:2017-05-01 00:00:00