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 Brunswick, NJ. PATIENTS:62 ASA I, II, and III patients undergoing ESWL. INTERVENTIONS:The control group (n = 29) received physician-controlled analgesia with continuous infusions (0.75 mcg/kg/min) and intermittent boluses (5 mcg/kg) of alfentanil. PCA patients (n = 33) initially received alfentanil 0.5 mcg/kg followed by a continuous background infusion (0.2 to 0.5 mcg/kg/min) and self-administered alfentanil (3 to 5 mcg/kg) with a 5-minute lockout period. Bolus doses and infusion rates were determined by patient comfort and cardiorespiratory response to alfentanil. MEASUREMENTS AND MAIN RESULTS:Prior to the procedure, the patients completed two questionnaires (State-Trait Anxiety Inventory and Multidimensional Health Locus of Control Scales). During ESWL, blood pressure, heart rate, respiratory rate, oxygen saturation, end-tidal CO2, and pain and sedation levels were measured at 0, 800, 1,600, 2,400, and 3,000 shock waves. The total doses of alfentanil administered were calculated. PCA patients received 31% less alfentanil than control group patients (p < 0.0001). Patients with more preoperative anxiety required larger doses of alfentanil (p < 0.05). The pain level was slightly higher in the patients receiving PCA (p > 0.05) but most patients reported either no or only mild pain. Side effects from the therapy, such as nausea and vomiting, were either not present or were mild in both groups, with one patient (3% to 4%) in each group reporting mild nausea. Both patients and urologists were very satisfied with the pain management in both groups. CONCLUSIONS:PCA is a useful alternative to physician-controlled analgesia during ESWL since it provides equivalent pain control while using less alfentanil.
journal_name
J Clin Anesthjournal_title
Journal of clinical anesthesiaauthors
Kortis HI,Amory DW,Wagner BK,Levin R,Wilson E,Levin A,Pitchford DE,Pollak Pdoi
10.1016/0952-8180(95)00008-6subject
Has Abstractpub_date
1995-05-01 00:00:00pages
205-10issue
3eissn
0952-8180issn
1873-4529pii
0952818095000086journal_volume
7pub_type
临床试验,杂志文章,随机对照试验abstract:STUDY OBJECTIVE:To test the hypothesis that the change of body and head position affects upper airway patency during midazolam sedation. DESIGN:Clinical study using 30 healthy subjects. SETTING:Research unit for sleep study. INTERVENTIONS:We used a pressure-flow relationship to evaluate critical closing pressure (Pc...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2005.08.010
更新日期:2006-05-01 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:STUDY OBJECTIVES:To determine alfentanil levels with a specific radioimmunoassay in serum and ovarian follicular fluid. DESIGN:Observational study. SETTING:University hospital. PATIENTS:14 ASA status I women undergoing oocyte retrieval for in vitro fertilization. INTERVENTIONS:General anesthesia was induced with al...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章
doi:10.1016/0952-8180(96)00035-9
更新日期:1996-06-01 00:00:00
abstract::Obstructive sleep apnea (OSA) is associated with postoperative airway obstruction, hypoxemia, cardiac arrhythmias, cardiorespiratory arrest, hypoxic encephalopathy, and death. Three cases highlighting important issues in patients with OSA are presented that occurred prior to and after implementation of an OSA protocol...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2008.08.023
更新日期:2009-06-01 00:00:00
abstract:STUDY OBJECTIVE:Some outpatient procedures are performed under sedation with dexmedetomidine, although the effect of dexmedetomidine on cognitive function remains unclear. This study investigated the effect of dexmedetomidine on cognitive function in healthy volunteers. DESIGN:Observation study in volunteers. SETTING...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2016.03.017
更新日期:2016-09-01 00:00:00
abstract::During surgical removal of tumors of the skull base or cerebellopontine angle with brainstem compression, the vagus nerve is at a high risk for injury that can result in permanent or transient swallowing and speech dysfunction. Intramuscular recording of cricothyroid muscle can be used for vagal nerve mapping during i...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2015.01.002
更新日期:2015-05-01 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::A parturient presented at 35 weeks' gestation with worsening neurological symptoms caused by syringomyelia. She underwent urgent cesarean delivery. The etiology and anesthetic considerations for an obstetrical patient with syringomyelia are discussed. ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2011.03.007
更新日期:2011-12-01 00:00:00
abstract:OBJECTIVES:To determine the psychometric outcomes of patients participating in an extensive patient-centered verification process before receiving sedation for regional anesthesia. DESIGN:Survey. SETTING:Perioperative areas of university-affiliated hospital. PATIENTS:Two hundred eligible patients scheduled for elect...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2014.10.009
更新日期:2015-05-01 00:00:00
abstract:STUDY OBJECTIVE:To investigate whether betamethasone decreases the incidence of postoperative nausea/vomiting (PONV) and reduces postoperative pain following partial mastectomy. DESIGN:Prospective randomized, double-blinded study. SETTING:Operating room and Postanesthesia Care Unit of a university hospital. PATIENTS...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2014.02.006
更新日期:2014-09-01 00:00:00
abstract::The use of direct oral anticoagulants including apixaban, rivaroxaban, and dabigatran, which are approved for several therapeutic indications, can simplify perioperative and postoperative management of anticoagulation. Utilization of regional neuraxial anesthesia in patients receiving anticoagulants carries a relative...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,评审
doi:10.1016/j.jclinane.2016.02.028
更新日期:2016-08-01 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::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::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 and compare the efficacy of various pretreatment agents to attenuate or prevent opioid-induced muscle rigidity using a well-established, previously described clinical protocol. DESIGN:Prospective, controlled, single-blind, partially randomized study. SETTING:Large medical center. PATIENTS...
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)90087-6
更新日期:1994-11-01 00:00:00
abstract:STUDY OBJECTIVE:To compare a multiport, firm-tipped, close-ended, epidural catheter (Portex catheter) with a uniport, open-ended, soft-tipped, wire-reinforced catheter (Arrow catheter) in obstetric patients. STUDY DESIGN:Prospective data collection for intradepartmental quality assurance. SETTING:Obstetric unit in a ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(00)00116-1
更新日期:2000-03-01 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 OBJECTIVE:To assess the clinical impact of paravertebral blocks (PVBs) on the immediate outcome of patients undergoing radical prostatectomy. DESIGN:Retrospective review. SETTING:Urology ward of a university medical center. MEASUREMENTS:Records of 100 consecutive patients who underwent a radical prostatectomy ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2006.12.003
更新日期:2007-06-01 00:00:00
abstract:STUDY OBJECTIVE:To develop categories of behavior that define an applicant's aptitude for anesthesia, and to attempt to determine the relative importance of these behaviors to successful residency performance. DESIGN:Prospective open study. SETTING:Anesthesia residencies at three midwest university teaching hospitals...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(97)00195-5
更新日期:1997-12-01 00:00:00
abstract:STUDY OBJECTIVE:To determine whether adding ephedrine to propofol is as effective as adding lidocaine at reducing injection pain, and its effects on hemodynamics. DESIGN:Randomized, double-blinded, controlled trial. SETTING:District general hospital in the United Kingdom. PATIENTS:156 adult, ASA physical status I, I...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2008.06.018
更新日期:2009-02-01 00:00:00
abstract::Approximately 2 million closed head injuries (CHIs) occur yearly in the United States. Twenty-five percent of these injuries require hospitalization, and 70,000 to 90,000 of those hospitalized suffer long-term disability. This case conference details one such case of CHI in which the patient ultimately died. Close att...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(05)80020-0
更新日期:1994-09-01 00:00:00
abstract:STUDY OBJECTIVE:The objective was to present a proof of concept for a simple and consistently successful ultrasonograpy (US)-guided technique to block the internal branch of the superior laryngeal nerve (iSLN). DESIGN:This was a volunteer and cadaver anatomy study. SETTING:The setting was an anesthesiology department...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2015.07.016
更新日期:2015-11-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the cerebrospinal fluid (CSF): total plasma concentration ratio of ketorolac tromethamine following a single intramuscular (IM) dose. DESIGN:Open, single-dose, IM-administration study. SETTING:General operating theaters of a medical school hospital. PATIENTS:29 ASA physical status I and ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(93)90061-i
更新日期:1993-11-01 00:00:00
abstract:STUDY OBJECTIVES:To evaluate the efficacy and safety of granisetron-droperidol combination for the prevention of postoperative nausea and vomiting (PONV) after middle ear surgery. DESIGN:Prospective, randomized, double-blind study. SETTING:University hospital. PATIENTS:150 ASA physical status I patients (108 females...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验,收录出版
doi:10.1016/s0952-8180(99)00011-2
更新日期:1999-03-01 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:STUDY OBJECTIVES:The aim of the present study was to assess the quality of recovery from anesthesia in patients undergoing laparoscopic cholecystectomy (LC) under total intravenous anesthesia, who received either methadone or morphine for post-surgical analgesia by means of questionnaire Quality of Recovery-40 (QoR-40)...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2018.09.031
更新日期:2019-03-01 00:00:00
abstract:STUDY OBJECTIVES:To track physician and nursing practice regarding preoperative pregnancy screening and testing in a setting where testing is the established policy. DESIGN:Prospective study. SETTING:University-affiliated, urban, tertiary care pediatric hospital. PATIENTS:261 menarcheal patients, aged 10 to 34 years...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(98)00136-6
更新日期:1999-02-01 00:00:00
abstract:STUDY OBJECTIVE:To investigate the effects of tympanometric changes on the frequency of postoperative nausea and vomiting (PONV). DESIGN:Prospective, observational study. SETTING:University hospital. PATIENTS:49 ASA physical status I, nonpremedicated children undergoing elective strabismus surgery. INTERVENTIONS:Fr...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2006.05.027
更新日期:2007-03-01 00:00:00
abstract:STUDY OBJECTIVE:Our hypothesis was that a pre-operative posteromedial quadratus lumborum (QL) block would reduce postoperative morphine consumption and provide superior analgesia in the setting of multimodal analgesia compared with a lateral transversus abdominis plane (TAP) block for laparoscopic colorectal surgery. ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2020.109716
更新日期:2020-06-01 00:00:00
abstract:STUDY OBJECTIVE:Erector spinae plane (ESP) block is a novel regional anesthesia technique and gaining importance for postoperative pain management. Since it was first described, the clinicians wonder if this new simple technique can replace paravertebral block (PVB). We aimed to compare the postoperative analgesic effe...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2019.06.036
更新日期:2020-02-01 00:00:00