Intrathecal Morphine for Analgesia in Minimally Invasive Cardiac Surgery: A Randomized, Placebo-controlled, Double-blinded Clinical Trial

BackgroundIntrathecal morphine decreases postoperative pain in standard cardiac surgery. Its safety and effectiveness have not been adequately evaluated in minimally invasive cardiac surgery. The authors hypothesized that intrathecal morphine would decrease postoperative morphine consumption after minimally invasive cardiac surgery.MethodsIn this randomized, placebo-controlled, double-blinded clinical trial, patients undergoing robotic totally endoscopic coronary artery bypass received either intrathecal morphine (5 mcg/kg) or intrathecal saline before surgery. The primary outcome was postoperative morphine equivalent consumption in the first 24 h after surgery; secondary outcomes included pain scores, side effects, and patient satisfaction. Pain was assessedvia visual analog scale at 1, 2, 6, 12, 24, and 48 h after intensive care unit arrival. Opioid-related side effects (nausea/vomiting, pruritus, urinary retention, respiratory depression) were assessed daily. Patient satisfaction was evaluated with the Revised American Pain Society Outcome Questionnaire.ResultsSeventy-nine patients were randomized to receive intrathecal morphine (n = 37) or intrathecal placebo (n = 42), with 70 analyzed (morphine 33, placebo 37). Intrathecal morphine patients required significantly less median (25th to 75th percentile) morphine equivalents compared to placebo during first postoperative 24 h (28 [16 to 46] mgvs. 59 [41 to 79] mg; difference, –28 [95% CI, –40 to –18];P
Source: Anesthesiology - Category: Anesthesiology Source Type: research

Related Links:

Orv Hetil. 2021 Oct 17;162(42):1671-1677. doi: 10.1556/650.2021.32332.ABSTRACTÖsszefoglaló. A COVID-19-fertőzésen átesett betegek közül többen elhúzódó panaszokról számolnak be a felépülést követően, sokaknál tartósan fennáll a köhögés, a nehézlégzés, a mellkasi fájdalom, a légszomj attól függetlenül, hogy enyhe vagy súlyosabb tüneteket okozott a koronavírus. A betegek erőtlennek érzik magukat, erős f&aacut...
Source: Orvosi Hetilap - Category: General Medicine Authors: Source Type: research
Eur Rev Med Pharmacol Sci. 2021 Sep;25(17):5561-5577. doi: 10.26355/eurrev_202109_26669.ABSTRACTWe aimed this systematic review to analyze and review the currently available published literature related to long COVID, understanding its pattern, and predicting the long-term effects on survivors. We thoroughly searched the databases for relevant articles till May 2021. The research articles that met our inclusion and exclusion criteria were assessed and reviewed by two independent researchers. After preliminary screening of the identified articles through title and abstract, 249 were selected. Consequently, 167 full-text art...
Source: Pharmacological Reviews - Category: Drugs & Pharmacology Authors: Source Type: research
Dr. David Prezant was knocked fully airborne at 9:59 on the morning of Sept. 11, 2001. He didn’t see the impact coming, but he felt it when it hit—and it nearly killed him. Little more than an hour earlier, Prezant, then the deputy chief medical officer of the Fire Department of New York, was headed for his usual workplace at the FDNY’s Office of Medical Affairs, just across the Manhattan Bridge in Brooklyn. He had already heard that a plane had hit the North Tower of the World Trade Center, and he reckoned that it was an accident. By the time he reached his office, however, the South Tower had been struc...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized healthscienceclimate Source Type: news
ConclusionWe did not find sufficient evidence that PD is an independent risk factor for severe COVID-19 and death. Larger studies with controls are required to understand this further. Longitudinal follow-up of these participants will allow for observation of possible long-term effects of COVID-19 in PD patients.
Source: Journal of Neurology - Category: Neurology Source Type: research
ConclusionsHalf of patients seeking medical help for post-acute COVID-19 syndrome lack SARS-CoV-2 immunity. The presence of SARS-CoV-2 immunity, or not, had no consequence on the clinical or biologic characteristics of post-acute COVID-19 syndrome patients, all of whom reported severe fatigue, altered quality of life and psychologic distress.
Source: Infectious Diseases and Therapy - Category: Infectious Diseases Source Type: research
More News: Anesthesia | Anesthesiology | Clinical Trials | Coronary Artery Bypass Graft | Cough | Depression | Intensive Care | Lower Endoscopy | Morphine | Pain | Pain Management | Respiratory Medicine