Abstract:
BACKGROUND:Multimodal analgesia is considered the leading principle for post-operative pain treatment, but no gold standard after total knee arthroplasty (TKA) exists. AIM:To investigate the beneficial and harmful effects of one or two doses of 24 mg intravenous dexamethasone (DXM) as part of a multimodal analgesic regimen (paracetamol, NSAID and perioperative local infiltration analgesia) after TKA. We hypothesize that addition of DXM will reduce post-operative opioid consumption. METHODS:DEXamethasone twice for pain treatment after TKA is a randomized, blinded, three-group multicentre clinical trial. Participants will be randomized to one of three groups: placebo, single dose of DXM or two consecutive doses of DXM. Participants, treatment providers and investigators will be blinded to the allocated intervention. The primary outcome is total opioid consumption (units of morphine equivalents) 0-48 hours post-operatively. INCLUSION CRITERIA:unilateral, primary TKA; age ≥18 years; American Society of Anesthesiologists-Score 1-3; Body Mass Index ≥18 and ≤40; for women-not pregnant; and written informed consent. EXCLUSION CRITERIA:allergy or contraindications against trial medication; daily use of high dose opioid and/or use of methadone/transdermal opioids; daily use of systemic glucocorticoids; dysregulated diabetes; and patients suffering from alcohol and/or drug abuse. Four-hundred-and-eighty-six eligible participants are needed to detect or discard a difference of 10 mg morphine equivalents 0-48 hours post-operatively maintaining a familywise error rate of 0.05 and a power of 90% for the three possible pairwise comparisons. DISCUSSION:Recruiting is planned to commence September 2018 and expected to finish March 2020. TRIAL REGISTRATION:EudraCT: 2018-001099-39 (08/06-18); ClinicalTrials.gov: NCT03506789 (24/04-2019). Editorial Comment This is the protocol for the largest randomized clinical trial investigating the effect of one or two doses of dexamethasones on pain treatment after total knee arthroplasty. Due to the pragmatic and rigerous design this study will deliver results of high quality and external validity.
journal_name
Acta Anaesthesiol Scandjournal_title
Acta anaesthesiologica Scandinavicaauthors
Gasbjerg KS,Hägi-Pedersen D,Lunn TH,Jakobsen JC,Overgaard S,Pedersen NA,Bagger J,Lindholm P,Brorson S,Schrøder HM,Thybo KH,Mathiesen Odoi
10.1111/aas.13481subject
Has Abstractpub_date
2020-02-01 00:00:00pages
267-275issue
2eissn
0001-5172issn
1399-6576journal_volume
64pub_type
杂志文章abstract::In order to antagonize immediate postoperative somnolence, 24 surgical patients were given a two-rate infusion of physostigmine, aiming at a constant plasma concentration in the range of 1 to 10 ng/ml. Plasma concentrations of physostigmine were determined during infusion and after infusion and the effects of physosti...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1989.tb02991.x
更新日期:1989-11-01 00:00:00
abstract::Six voltage waveforms were devised to simulate pressure curves of varying configuration for use in artificial ventilation. These waveforms were subjected to Fourier analysis and terms of the resulting series applied to a simple two-branch resistive-capacitive circuit intended to represent a lung analog using computer ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1984.tb02036.x
更新日期:1984-04-01 00:00:00
abstract::The effect of blood transfusions on the electrolyte, metabolic and hemodynamic status of 31 patients undergoing major laparotomies was studied. Two groups were compared: Group I, 11 patients receiving continuous intraoperative blood transfusions exceeding 5 units at a rate over 0.3 ml/kg/min, and Group II, 20 patients...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1986.tb02384.x
更新日期:1986-02-01 00:00:00
abstract:BACKGROUND:Wound infiltration with local anesthetics does not reliably produce satisfactory postoperative analgesia, and the dose of local anesthetic which may be safely administered is limited by the potential for systemic toxicity. This study evaluated the efficacy of a slow-release liposomal bupivacaine formulation ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1997.tb04666.x
更新日期:1997-02-01 00:00:00
abstract::The conformity of a pre-shaped endotracheal tube to the shape of the airway during endotracheal intubation was studied from lateral radiographs in patients lying supine on the operating table, with the neck in the normal, extended and flexed positions. A computer programme calculated the anterior contour of the pre-sh...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1983.tb01963.x
更新日期:1983-08-01 00:00:00
abstract::Psychomotor and cognitive dysfunction in cancer patients can be classified into two main categories according to etiology: disease-induced factors (metabolic disturbances, brain metastasis, pain, etc.) and treatment-related factors (drugs, antineoplastic therapy, etc.). In particular, the effects of chronic opioid adm...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1997.tb04631.x
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:We aimed to investigate the physiological mechanism and spatial distribution of increased physiological dead-space, an early marker of ARDS mortality, in the initial stages of ARDS. We hypothesized that: increased dead-space results from the spatial redistribution of pulmonary perfusion, not ventilation; suc...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.13702
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:The aim of this study was to determine the incidence and severity of pulmonary aspiration of gastric contents during anaesthesia, to determine the short- and long-term morbidity, and to evaluate present routines for preoperative gastric emptying. During the study period, preoperative gastric emptying was don...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1996.tb05548.x
更新日期:1996-11-01 00:00:00
abstract:INTRODUCTION:Advanced life support (ALS) guidelines recommend ultrasound to identify reversible causes of cardiac arrest. Right ventricular (RV) dilatation during cardiac arrest is commonly interpreted as a sign of pulmonary embolism. The RV is thus a focus of clinical ultrasound examination. Importantly, in animal stu...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.12911
更新日期:2017-08-01 00:00:00
abstract::Axillary perivascular injection of 50 ml blue-stained gelatine was made in 20 cadavers, and a total dissection of the axilla was performed. The distribution of injected gelatine and the contact between nerves and gelatine were examined on cross-sections of the neurovascular bundle. The spread of gelatine was character...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1986.tb02359.x
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND:To compare the incidence of postural post-dural puncture headache (PPDPH) after spinal anaesthesia using two different 0.40 mm O.D. (27 g) spinal needles: pencil-point needle and Quincke needle. In addition, a meta-analysis of studies comparing small bore spinal needles with regard to development of PPDPH wa...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,meta分析,随机对照试验
doi:10.1034/j.1399-6576.2000.440603.x
更新日期:2000-07-01 00:00:00
abstract::The purpose of this study was to compare the frequency of psychomimetic reactions after 24 h and 3 months following total intravenous anaesthesia with propofol and neurolept anaesthesia. Forty otherwise healthy female patients were randomly divided into two groups. All were undergoing elective gynaecological laparotom...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1399-6576.1993.tb03593.x
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:The larger size of the first sacral nerve root has been reported to be an unfavorable factor leading to sacral sparing in epidural anesthesia. Previous studies have shown that an adequate analgesic effect of the epidural block was achieved with the catheter placement in the caudal direction. In this study, t...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1399-6576.2005.00620.x
更新日期:2005-03-01 00:00:00
abstract::A 61-year-old woman (57 kg, 171 cm) underwent surgery under general anaesthesia with desflurane 5.8-6.1 vol. % end-tidal, remifentanil 0.2-0.4 μg/kg/min and rocuronium 35 mg (0.61 mg/kg). On return of the second twitch in the train-of-four (TOF) stimulation measured by acceleromyography, sugammadex 120 mg (2.1 mg/kg) ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
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更新日期:2015-04-01 00:00:00
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journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1399-6576.2011.02574.x
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:After an ischemia time of 1 h during aortic aneurysm surgery, muscle glutathione redox-status is not altered, indicating that this ischemic insult is well within the scavenging capacity of muscle glutathione, the most important endogenous scavenger. In the present study, the impact of elective aorto-bifemora...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2006.01021.x
更新日期:2006-07-01 00:00:00
abstract::The need to conserve a patient's own blood and avoid homologous transfusion is now well recognized. Therefore, techniques designed to reduce requirements for homologous blood transfusions have been developed. One of the methods is autotransfusion of shed mediastinal blood after open-heart surgery. The objectives of th...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1995.tb04230.x
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journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1976.tb05011.x
更新日期:1976-01-01 00:00:00
abstract::The present study was undertaken to determine the site of action of trimethaphan in causing neuromuscular blockade using isolated rat and frog muscle. Trimethaphan and d-tubocurarine attenuated the twitch tension developed by nerve stimulation, trimethaphan being 1/100 to 1/200 as potent as d-tubocurarine. Neostigmine...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1988.tb02700.x
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journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章,meta分析,评审
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更新日期:2014-09-01 00:00:00
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journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1997-11-01 00:00:00
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journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.12739
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:The aim of this study was to compare desflurane and isoflurane for spinal procedures requiring moderate levels of controlled arterial hypotension, when these agents were administered via a semi-closed circuit at 1 l x min(-1) fresh gas flow. METHODS:After ethics committee approval and written informed conse...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2000-10-01 00:00:00
abstract:BACKGROUND:Lung tissue is metabolically active and consumes oxygen. The oxygen content difference between arterial and mixed venous blood does not include the effect of pulmonary tissue oxygen uptake. Thus, oxygen consumption (VO2) of the lung should be reflected as a difference between VO2 measured by gas exchange and...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1997.tb04792.x
更新日期:1997-08-01 00:00:00
abstract::The effect of changing the volume of cerebro-spinal fluid (CSF) before spinal anaesthesia with 3 ml of isobaric 0.5% bupivacaine was investigated in 60 elderly (58-77 years) orthopaedic or urological patients. The patients were randomly allocated to three groups. They received the spinal anaesthetic either with or wit...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1985-08-01 00:00:00
abstract::The administration of glucocorticoids has been used to inhibit the cytokine production in patients undergoing cardiac surgery during cardiopulmonary bypass. In this case report the cytokine response in a 43-year-old man undergoing operation for an ACTH-producing lung tumor is presented. There had been clinical symptom...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1997.tb04686.x
更新日期:1997-02-01 00:00:00
abstract::A new method of artificial ventilation, intermittent high frequency ventilation (IHFV), is described in which high frequency ventilation (HFV) is intermittently interrupted so that short periods of ventilation and pauses in ventilation occur in sequence several times a minute. During the pauses in ventilation the incr...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1988.tb02732.x
更新日期:1988-05-01 00:00:00
abstract:BACKGROUND:Recently, clinical reports have suggested a relationship between the occurrence of hyperalgesia, allodynia and/or myoclonus and treatment with high doses of morphine in humans. Although few clinical descriptions of these phenomena are available, experimental work supports the notion that high doses of morphi...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1998.tb05378.x
更新日期:1998-10-01 00:00:00
abstract::This randomized, double-blind and double-dummy study was carried out in order to compare the perioperative sedation after premedication with either brotizolam 0.25-0.50 mg sublingually or diazepam 5-10 mg orally. Sixty-two patients aged 18-60 years scheduled for minor gynaecological surgery in general anaesthesia were...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1399-6576.1992.tb03560.x
更新日期:1992-11-01 00:00:00
abstract::Forty patients who underwent elective cholecystectomy were examined preoperatively and during the first postoperative week by physical examination, measurement of FVC and FEV1, arterial pH and blood gas analyses, and chest x-ray. Postoperative pulmonary complications (p.p.c.) were detected in 30 (75%) of the patients....
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1977.tb01211.x
更新日期:1977-01-01 00:00:00