ABSTRACT
BACKGROUND: General anesthesia often produces some degree of hypothermia and hypothermia causes much more blood loss during surgery than normothermia. Electrically heated humidifiers (EHHs) have been used for patients under general anesthesia and in the intensive care unit. However, the benefits of the EHH have not been widely reported in the literature. METHODS: Patients scheduled for posterior lumbar spine fusion, were randomly assigned to a mechanically ventilated with EHH circuit group or to a conventional respiratory circuit group. Their tympanic membrane temperature was monitored every 30 min after induction up to 180 min, and perioperative blood losses, transfusion requirements during surgery, and other complications were noted. RESULTS: Patients in the control group (n = 40) showed a lower mean body temperature at all times than immediately after induction, while the EHH group (n = 40) showed a lower body temperature from 60 minute after induction comparing to the initial temperature. Furthermore, patients in the EHH group had a higher mean body temperature than patients in the control group during surgery (35.9 +/- 0.4 vs 35.4 +/- 0.5, P < 0.001). Mean intraoperative blood loss (9.75 +/- 5.4 vs 7.48 +/- 3.9, P = 0.035) and transfusion requirements (57.5% vs 25%, P = 0.006) were significantly less in the EHH group, but postoperative blood loss, duration of hospitalization, and other complications were not significantly different in the two study groups. CONCLUSIONS: The use of an electrically heated humidifier did not prevent a body temperature drop under general anesthesia. However, it helped maintain body temperature and was associated less blood loss and transfusion requirement during surgery.
Subject(s)
Humans , Anesthesia, General , Body Temperature , Hospitalization , Hot Temperature , Hypothermia , Intensive Care Units , Postoperative Hemorrhage , Spine , Tympanic MembraneABSTRACT
BACKGROUND: Postoperative nausea and vomiting (PONV) is common complication of Patient-Controlled Analgesia (PCA) after surgery. The authors sought to determine whether a transdermal scopolamine (TDS) patch in combination with IV dexamethasone is more effective than IV dexamethasone alone or IV dexamethasone plus IV ramosetron for reducing PONV in patients receiving epidural PCA after major orthopedic surgery. METHODS: 120 patients that received epidural PCA with hydromorphone and ropivacaine after major orthopedic surgery under spinal anesthesia were allocated to 3 groups: Group D (n = 40) received IV dexamethasone 8 mg, Group DR (n = 40) received IV dexamethasone 8 mg plus IV ramosetron 0.3 mg, Group DS (n = 40) received IV dexamethasone 8 mg plus a TDS patch (Group DS, n = 40). Nausea and vomiting incidences, VAS for nausea, the use of additional antiemetics, and adverse effects (a dry mouth, blurred vision, drowsiness) during the first 24 hours postoperatively were subjected to analysis. RESULTS: The DS Group had a significantly higher rate of complete remission of PONV than the D and DR groups (82.5% vs 47.5%, and 50.0%, respectively), and had lower rates of nausea (17.5% vs 55.0%, and 50.0%), and vomiting (10.0% vs 50.0%, and 25.0%), and required less antiemetics (5.0% vs 35.0%, 22.5%) than group D and Group DR during the first 24 hours after surgery. Furthermore, no inter-group differences were observed with respect to adverse effects in the three groups. CONCLUSIONS: The prophylactic use of a TDS patch plus dexamethasone was found to be a more effective means of preventing PONV in patients that received epidural PCA after major orthopedic surgery than dexamethasone alone or dexamethasone plus ramosetron without adversely affecting side effects.
Subject(s)
Humans , Amides , Analgesia, Patient-Controlled , Anesthesia, Spinal , Antiemetics , Benzimidazoles , Dexamethasone , Hydromorphone , Incidence , Mouth , Nausea , Orthopedics , Passive Cutaneous Anaphylaxis , Postoperative Nausea and Vomiting , Scopolamine , Sorbitol , Tyramine , Vision, Ocular , VomitingABSTRACT
BACKGROUND:Hydromorphone is a semi-synthetic opioid that has recently been used for the control of acute and chronic pain.It has been reported that epidural infusion of hydromorphone provides rapid onset of analgesia and a lower incidence of side effects than morphine.However, comparative studies of hydromorphone and lipophilic opioids such as fentanyl are rare.Therefore, we compared the analgesic effects and side effects of hydromorphone infused epidurally with fentanyl in patients who underwent total knee arthroplasty. METHODS:In a randomized, double-blind manner, 79 patients (ASA I-III, aged 60?75) underwent total knee arthroplasty and were provided with patient-controlled epidural analgesia (PCEA) using a lumbar spinal/epidural-combined technique. Group HR (n = 39) received epidurally administered hydromorphone (4microg/ml) with 0.1% ropivacaine, while group FR (n = 40) received epidural fentanyl (2microg/ml) with 0.1% ropivacaine for 24 h after surgery at a rate of 5 ml/h. The visual analogue scale (VAS) was used to evaluate pain and the incidence of side effects such as nausea/vomiting, pruritis, dizziness, and respiratory depression were recorded at 4, 8, 12, 24 h after surgery. RESULTS:Group HR showed a lower VAS than group FR at 4, 12 and 24 h after surgery, but a higher incidence of nausea and vomiting at 8 h after surgery, and a higher incidence of pruritis at 8 and 12 h after surgery. None of the patients showed respiratory depression. CONCLUSIONS:Lumbar epidural infusion of hydromorphone more effectively controlled acute pain after total knee arthroplasty when compared with fentanyl, but some adverse effects such as nausea and vomiting appeared to occur more frequently.
Subject(s)
Aged , Humans , Acute Pain , Amides , Analgesia , Analgesia, Epidural , Analgesia, Patient-Controlled , Analgesics, Opioid , Arthroplasty , Dizziness , Fentanyl , Hydromorphone , Incidence , Knee , Nausea , Pruritus , Respiratory Insufficiency , VomitingABSTRACT
BACKGROUND:Hydromorphone is a semi-synthetic opioid that has recently been used for the control of acute and chronic pain.It has been reported that epidural infusion of hydromorphone provides rapid onset of analgesia and a lower incidence of side effects than morphine.However, comparative studies of hydromorphone and lipophilic opioids such as fentanyl are rare.Therefore, we compared the analgesic effects and side effects of hydromorphone infused epidurally with fentanyl in patients who underwent total knee arthroplasty. METHODS:In a randomized, double-blind manner, 79 patients (ASA I-III, aged 60?75) underwent total knee arthroplasty and were provided with patient-controlled epidural analgesia (PCEA) using a lumbar spinal/epidural-combined technique. Group HR (n = 39) received epidurally administered hydromorphone (4microg/ml) with 0.1% ropivacaine, while group FR (n = 40) received epidural fentanyl (2microg/ml) with 0.1% ropivacaine for 24 h after surgery at a rate of 5 ml/h. The visual analogue scale (VAS) was used to evaluate pain and the incidence of side effects such as nausea/vomiting, pruritis, dizziness, and respiratory depression were recorded at 4, 8, 12, 24 h after surgery. RESULTS:Group HR showed a lower VAS than group FR at 4, 12 and 24 h after surgery, but a higher incidence of nausea and vomiting at 8 h after surgery, and a higher incidence of pruritis at 8 and 12 h after surgery. None of the patients showed respiratory depression. CONCLUSIONS:Lumbar epidural infusion of hydromorphone more effectively controlled acute pain after total knee arthroplasty when compared with fentanyl, but some adverse effects such as nausea and vomiting appeared to occur more frequently.
Subject(s)
Aged , Humans , Acute Pain , Amides , Analgesia , Analgesia, Epidural , Analgesia, Patient-Controlled , Analgesics, Opioid , Arthroplasty , Dizziness , Fentanyl , Hydromorphone , Incidence , Knee , Nausea , Pruritus , Respiratory Insufficiency , VomitingABSTRACT
In order to investigate whether Eisenia bicyclis (EB) as a functional food material improves serum lipid status, supplementation of EB powder or EB extract to the high fat/cholesterol diet was tested in 6-week old male Sprague-Dawley rats for four weeks. In the first experiment, four kinds of seaweed powder-Eisenia bicyclis (EB), Undaria pinnatifida (UP), Laminaria japonica (LJ), and Ecklonia stolonifera (ES) were compared with alginic acid (ALG) as well as control. In the second experiment, EB water extract and EB ethanol extract and EB pill containing EB and LJ powder were compared with the EB powder. Amounts of dietary fiber contained in experimental diets were adjusted to provide 5% of diets. Serum total cholesterol was significantly lower only in rats fed LJ or EB powder, but HDL cholesterol was higher in rats fed UP, LJ, ES or EB powder. Ratios of HDL-/total cholesterol of all seaweed groups including ALG were significantly higher than that of the control group. Serum triglyceride was lower in LJ, EB and ES powder groups than the control group. In comparison of EB extracts, triglyceride level was decreased in rats fed only EB water extract as compared to control rats, but HDL cholesterol was elevated with both water and ethanol extracts. Serum levels of total cholesterol, triglyceride were decreased and HDL cholesterol was increased by the EB pill. Serum levels of thiobarbituric acid-reactive substances were lower in rats fed ES powder, and EB powder, EB water extract or EB pill, as compared to the control rats. Supplementation of EB powder and EB pill reduced serum level of GOT and GPT, respectively, as compared to the control group. In conclusion, EB and EB pill improve serum lipid status and may be utilized as ingredient of functional foods for the purpose of improving serum lipid profile and inhibiting peroxidation of lipids.
Subject(s)
Animals , Humans , Male , Rats , Alginates , Cholesterol , Cholesterol, HDL , Diet , Diet, High-Fat , Dietary Fiber , Ethanol , Functional Food , Glucuronic Acid , Hexuronic Acids , Laminaria , Rats, Sprague-Dawley , Seaweed , Thiobarbituric Acid Reactive Substances , Undaria , WaterABSTRACT
No abstract available.