Background: Our aim was to analyze anesthetic induction time and postoperative pain using spinal anesthesia versus general anesthesia with or without the use of peripheral nerve blocks (PNBs) in total knee arthroplasty. The hypothesis was that spinal anesthesia would be beneficial with respect to induction time and postoperative pain and that PNBs would complement this effect.
Methods: Patients were stratified according to demographics, American Society of Anesthesiologists physical status classification system (ASA), and opioid intake and divided into: (A) general anesthesia without PNB; (B) general anesthesia with PNB; (C) spinal anesthesia without PNB; and (D) spinal anesthesia with PNB. Endpoints were anesthetic induction time, opioid consumption, and pain. Of 559 patients, 348 (62.3%) received general anesthesia (consisting of group A with 46 and group B with 302 patients), and 211 (37.7%) spinal anesthesia (consisting of group C with 117 and group D with 94 patients).
Results: We observed significantly lower total opioid intake 48 hours postoperative when applying spinal anesthesia by 2.08 mg (P < .05) of intravenous morphine-equivalent, and a reduction of 7.0 minutes (P < .05) until skin incision. The application of a PNB achieved a reduction of piritramide intake of 3.59 mg (P < .05) 48 hours postoperative and lengthened induction time by 8.5 minutes (P < .05).
Conclusions: Statistically shorter anesthetic induction times without clinical relevance, but lower postoperative opioid dosages with clinical relevance were observed for patients undergoing total knee arthroplasty with spinal anesthesia. The additional application of PNBs led to a lower need for opioids and lower pain levels in the early postoperative phase.
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http://dx.doi.org/10.1016/j.arth.2023.10.018 | DOI Listing |
Lab Anim
January 2025
Environment and Climate Change Canada, Burlington, Canada.
This paper reviews the methods and approaches used to humanely anesthetize (render unconscious) and or euthanize (kill) laboratory fish (in research settings), with a specific focus on the fathead minnow. We surveyed the literature (333 scientific studies published 2004-2021) to examine euthanasia methods used for various life stages. Our findings showed that many published scientific papers do not provide an adequate description of anesthesia or euthanasia methods, particularly for larval fathead minnows.
View Article and Find Full Text PDFJ Clin Med
January 2025
"Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Neurofibromatosis is a genetic disorder arising de novo or with an autosomal dominant transmission that typically presents either at birth or in early childhood, manifesting through distinctive clinical features such as multiple café-au-lait spots, benign tumors in the skin, bone enlargement, and deformities. This literature review aims to resume the spectrum of maternal and fetal complications encountered in pregnant women with neurofibromatosis type 1 (NF1). Thorough research was conducted on databases such as Web of Science, PubMed, Science Direct, Google Scholar, and Wiley Online Library.
View Article and Find Full Text PDFAntibiotics (Basel)
January 2025
Department of Anesthesia and Intensive Care Unit, ULSS6 Euganea, 35013 Cittadella, Padova, Italy.
The pathogenesis of recurrent urinary tract infections (rUTIs), a common problem in the female population, is becoming better understood following recent studies of bacterial persistence and intracellular bacterial communities. Incorporating these new insights, we propose pulsed antibiotic therapy with intracellular activity as a possible treatment for rUTIs.
View Article and Find Full Text PDFBMC Anesthesiol
January 2025
Department of Anesthesiology, The Third People's Hospital of Bengbu, 38 Shengli Middle Road, Bengbu, 233000, China.
Background: The use of a fluid co-load has been shown to enhance hemodynamic stability and diminish the occurrence of hypotension after spinal anesthesia when paired with prophylactic norepinephrine. This research aimed to identify the effective dosages (ED and ED) of prophylactic norepinephrine boluses, in conjunction with a crystalloid co-load, for the prevention of hypotension after spinal anesthesia in cesarean delivery patients.
Methods: Patients were administered crystalloid co-loads at a dosage of 10 mL/kg, in addition to preventive norepinephrine dosages direct following spinal anesthesia administration.
Acta Anaesthesiol Scand
March 2025
Department of Anesthesia and Intensive care, University Hospital of Southern Denmark, Kolding, Denmark.
Background: Fast recovery after cesarean section is vital since the mother not only has to take care of herself but also the newborn. Recovery scores are useful tools to measure and compare recovery; however, standardized questionnaires may miss in-depth patient experiences. What is important to women in the postoperative period after cesarean section can vary in different populations, making it crucial to understand the specific needs of one's own population.
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