Abstract:
BACKGROUND:Movement-evoked pain is more severe than pain at rest and is likely to interfere more with functional recovery after surgery. OBJECTIVE:To compare triple vs. double nonopioid perioperative analgesic regimens in women undergoing abdominal hysterectomy. DESIGN:A randomised, parallel design, double-blind controlled trial. SETTING:A single-centre trial. Study period from November 2009 to July 2013. PATIENTS:Adults (>18 years) of American Society of Anesthesiologists' status 1 to 2 scheduled for abdominal hysterectomy. INTERVENTIONS:Patients were randomised to one of four study treatment groups: acetaminophen, meloxicam and gabapentin (AMG); acetaminophen and meloxicam; acetaminophen and gabapentin; and meloxicam and gabapentin. In addition to intravenous patient-controlled opioid analgesia, study treatments were administered for 48 h, starting 1 h preoperatively. MAIN OUTCOME MEASURES:The primary outcome was cough-evoked pain. Secondary outcomes included pain at rest, during sitting and peak expiration, opioid consumption, side effects, peak expiratory flow rate, timed up and go test (TUG), and modified Brief Pain Inventory (mBPI). RESULTS:Interim analysis indicated a minimal chance of demonstrating superiority of the triple regimen group over all three double regimen groups if the trial were to be recruited to planned sample size. Thus, the trial was prematurely terminated for futility. All four analgesic regimens were well tolerated. Exploratory analyses revealed consistent significant negative correlations between pain and TUG and between pain and interference with activity, walking and sleep. CONCLUSION:This trial failed to demonstrate substantial benefits with the addition of a third nonopioid analgesic to three different double-drug regimens. Further research is needed that will more definitively support expanding multimodal analgesic practices. Our results demonstrate consistent correlations between evoked pain and functional outcomes further emphasising the need for improved analgesic regimens that will accelerate postsurgical functional recovery. TRIAL REGISTRATION:International Standard Randomised Controlled Trial Number Register 12723675.
journal_name
Eur J Anaesthesioljournal_title
European journal of anaesthesiologyauthors
Gilron I,Tu D,Dumerton-Shore D,Duggan S,Rooney R,McGrath M,Orr Edoi
10.1097/EJA.0000000000000190subject
Has Abstractpub_date
2015-04-01 00:00:00pages
269-76issue
4eissn
0265-0215issn
1365-2346journal_volume
32pub_type
杂志文章,随机对照试验abstract:BACKGROUND AND OBJECTIVE:Astrocytes exposed to hypoxia produce pro-inflammatory cytokines and upregulate intercellular adhesion molecule-1 on cerebral endothelium. This study investigated the effects of midazolam on this response. METHODS:Mouse astrocytes were exposed to 4 h of hypoxia and 24 h of reoxygenation. Astro...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021506000652
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abstract::The molecular mechanism of volatile anaesthetic action on presynaptic glutamate release is not clear. An inhibitory effect on voltage-gated calcium channels has been proposed. The present study examines the effect of isoflurane on cytosolic free calcium and synaptic glutamate release from isolated nerve terminals. Syn...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:
更新日期:1998-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Recent evidence indicates that platelet function may recover more rapidly after cessation of aspirin therapy than previously thought. The present study evaluated the effect of aspirin on platelet function using platelet aggregometry in healthy individuals and in aspirin-treated patients schedul...
journal_title:European journal of anaesthesiology
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doi:10.1097/EJA.0b013e328335b354
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abstract::Data on 13 043 operations were abstracted from 108 878 anaesthetic records in the Cardiff Anaesthetic Record System. Nine groups of surgical operations with high mortality in hospital were identified. These records were analysed using a logistic regression model to determine the probability of death in hospital. Varia...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
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abstract:BACKGROUND AND OBJECTIVE:Left ventricular non-compaction (LVNC) is a relatively uncommon cardiomyopathy. The implications of the presence of LVNC in the perioperative period are unknown. The objective of this study was to determine the impact of LVNC on post-operative complications. METHODS:This retrospective cohort s...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0b013e328341014c
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abstract:BACKGROUND:Dual-tasking, the need to divide attention between concurrent tasks, causes a severe increase in workload in emergency situations and yet there is no standardised training simulation scenario for this key difficulty. OBJECTIVES:We introduced and validated a quantifiable source of divided attention and inves...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
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abstract:BACKGROUND:Neuromuscular blockade (NMB) monitoring is essential to avoid residual NMB. While the adductor pollicis is the recommended site for monitoring recovery, it is not always accessible. The flexor hallucis brevis could be an interesting alternative. OBJECTIVE:The aim of our study was to compare NMB onset and re...
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abstract:BACKGROUND:The objective of this study was to determine the intracranial, cardiovascular and respiratory changes induced by conversion to high-frequency oscillator ventilation from conventional mechanical ventilation at increasing airway pressures. METHODS:In this study, 11 anaesthetized sheep had invasive cardiovascu...
journal_title:European journal of anaesthesiology
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abstract:BACKGROUND:The risk/benefit of continuing low-dose acetylsalicylic acid (aspirin) for secondary prevention in the perioperative period is still debated. The primary aim of this study was to determine the effect of acetylsalicylic acid compared with placebo on platelet function in the perioperative period. METHODS:This...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,多中心研究,随机对照试验
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abstract:BACKGROUND:Robot-assisted thoracoscopic thymectomy has brought new challenges to the anaesthesiologists. Here we present a study of 17 patients undergoing robotic thymectomy. PATIENTS AND METHODS:The present study was a prospective study, which included 17 patients with myasthenia gravis scheduled for robot-assisted t...
journal_title:European journal of anaesthesiology
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abstract:BACKGROUND AND OBJECTIVE:The kneeling prone position is often used for low back surgery in order to decrease intraoperative bleeding and increase the surgical exposure of the vertebral canal. The aim of this study was to assess effects of the kneeling prone position on respiratory gas exchange focusing on oxygen consum...
journal_title:European journal of anaesthesiology
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abstract::Malignant hyperthermia is an autosomal-dominant inherited disorder of the skeletal muscle cell characterized by a hypermetabolic response to all commonly used inhalational anaesthetics and depolarizing muscle relaxants. The clinical syndrome includes muscle rigidity, hypercapnia, tachycardia and myoglobinuria as resul...
journal_title:European journal of anaesthesiology
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journal_title:European journal of anaesthesiology
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abstract:BACKGROUND:Propofol may help to protect against ischaemic acute kidney injury (AKI); however, research on this topic is sparse. OBJECTIVE:The current study aimed to investigate whether there were differences in the incidence of postoperative AKI after lung resection surgery between patients who received propofol-based...
journal_title:European journal of anaesthesiology
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journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:European journal of anaesthesiology
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pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:European journal of anaesthesiology
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journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
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