In a double-blind, prospective trial, 90 patients scheduled to undergo elective plastic surgery were allocated randomly to three groups, to receive lidocaine 20 mg (n = 30), a combination of lidocaine 20 mg and nitroglycerin 0.1 mu g/kg (n = 30), or normal saline as a placebo (n = 30), with venous occlusion for 1 min, followed by the administration of 25 % of the total calculated dose of propofol (2 mg/kg) into a dorsal hand vein. The pain intensity during the propofol injection was assessed SB273005 chemical structure using a four-point scale (0 = none, 1 = mild, 2 = moderate, 3 = severe). Hemodynamic variables-mean arterial pressure
and heart rate-were measured during the preoperative and intraoperative periods.
A significantly higher proportion of patients in the placebo group (83 %) experienced pain LY2090314 mouse compared to the lidocaine and combination groups (43 and 7 %, respectively; both, P < 0.01). The incidence of pain in the combination group was lower than that in the lidocaine group (P < 0.01).
The pain score (median) was lower in the lidocaine (0) and combination (0) groups than in the placebo group (2); (P < 0.01). The hemodynamic variables were similar in the three groups.
A combination of nitroglycerin 0.1 mu g/kg and lidocaine 20 mg with venous occlusion for 1 min was more effective than lidocaine 20 mg alone in decreasing pain during propofol injection.”
“Objective: Evaluate the prevalence of fever in the first 48 h after cardiac arrest and its effect on outcomes.
Methods: Review of patients treated between 1/1/2005 and 6/30/2010. Fever was defined as T >= 38.0 degrees C. We classified categories of post-cardiac arrest illness severity as (I) awake, (II) coma + mild cardiopulmonary dysfunction (SOFA cardiac + respiratory score <4), (III) coma + moderate-severe cardiopulmonary dysfunction, Vorinostat research buy and (IV) deep coma. Associations between fever and survival or good neurologic outcome were examined between
hypothermia (TH) and non-TH groups.
Results: In 336 patients, mean age was 60 years (SD 16), 63% experienced out-of-hospital cardiac arrest and 65% received TH. A shockable rhythm was present in 40%. Post arrest illness severity was category II in 38%, category III in 20%, and category IV in 42%. Fever was present in 42% of subjects, with a post-arrest median onset of 15 h in the non-TH cohort and 36 h in TH cohort. Fever was not associated with survival within the whole cohort (OR 0.32, CI 0.15, 0.68) or TH cohort (OR 1.21, CI 0.69, 2.14), but was associated with survival in non-TH cohort (OR 0.47, CI 0.20, 1.10). Fever was not associated with good outcomes in the whole cohort (OR 0.83, CI 0.49, 1.40), TH cohort (OR 1.09, CI 0.56, 2.12) or non-TH cohort (OR 0.34, CI 0.11, 1.06).
Conclusions: The development of fever within the first 48 h after ROSC is common. Fever is associated with death in non-TH patients.