Publications by authors named "Maggie Lesley"
Background: Patients undergoing liver transplantation frequently but inconsistently require massive blood transfusion. The ability to predict massive transfusion (MT) could reduce the impact on blood bank resources through customization of the blood order schedule. Current predictive models of MT for blood product utilization during liver transplantation are not generally applicable to individual institutions owing to variability in patient population, intraoperative management, and definitions of MT.
View Article and Find Full Text PDFStudy 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.
Article Synopsis
- Extended-release epidural morphine (EREM) is designed for postoperative pain relief lasting 48 hours, but its safety concerning respiratory depression compared to intravenous patient-controlled analgesia (IV-PCA) is unclear and prompted a meta-analysis.
- A systematic search of literature identified three qualifying randomized controlled trials that evaluated the rates of respiratory depression between EREM and IV-PCA using a random effects model for analysis.
- The findings revealed that EREM is significantly associated with higher odds of respiratory depression compared to IV-PCA, indicating that while EREM is effective for pain relief, it poses increased risk for respiratory issues.
Objective: Intradermal injection of local anesthetic often results in pain on injection due in part to the acidic pH of commercially prepared solutions, which are optimized to prolong shelf life. Although there are other possible explanations (eg, noxious properties of local anesthetics, pressure effect of infiltration), the etiology is most likely multifactorial. Although addition of bicarbonate to local anesthetics may decrease pain on intradermal injection, the extent of this analgesic effect is uncertain.
View Article and Find Full Text PDFBackground And Objectives: Painful diabetic peripheral neuropathy (DPN) is an increasingly prevalent disorder that is best managed through a multimodal approach. We examined the effects of pregabalin on pain control, sleep disturbance, and the patient's global impression of change (PGIC) for the treatment of this disorder.
Methods: Studies were identified using the National Library of Medicine's PubMed and EMBase databases (1966 to July 15, 2007).