Saturday, October 30, 2004

One Shot Eases Pain After Surgery

It is well known that the injection of a small dose of morphine into the epidural space or cerebral spinal fluid can provide significant post-operative pain relief for as long as 24 hours. The FDA has approved a liposome formulation of morphine that can double that duration. DepoDur, a morphine sulfate extended-release liposome injection, was approved in May, 2004.

""The recommended dose is 10 mg for caesarean section, 10-15 mg for lower abdominal surgery and 15 mg for major orthopaedic surgery of the lower extremities. Some patients may benefit from a dose of 20 mg.
...[snip]...
The most common adverse events reported during clinical trials were decreased oxygen saturation, hypotension, urinary retention, vomiting, constipation, nausea, pruritus, pyrexia, anemia, headache and dizziness.""

More information at SkyePharma.

[Via Yahoo! News: Health]



Wednesday, October 27, 2004

Yahoo! News - Anesthesiologists Vulnerable to Drug Abuse

Yahoo! News - Anesthesiologists Vulnerable to Drug Abuse:

""Drug abuse among some anesthesiologists may be linked to exposure to low doses of powerful anesthetic drugs administered intravenously to surgery patients, according to a University of Florida study.

Anesthesiologists who sit near a patient's head during surgery are subject to secondhand exposure to anesthetic drugs exhaled by the patient, explained Dr. Mark Gold, a distinguished professor with UF's McKnight Brain Institute.""

and

""Easy access to drugs is a current theory that seems to offer a simple explanation for higher addiction rates among anesthesiologists, said Dr. Mark Aronson, a professor of medicine at Harvard Medical School (news - web sites). However, drug usage is monitored much more closely by hospitals now. That makes access to those drugs more difficult and the easy access addiction theory less plausible.""

Wrong. (I love telling Harvard people that.) I have yet to meet a monitoring system I can't beat if I really want to divert drug.



Tuesday, October 26, 2004

Anesthesia Can Dim Elderly Patients' Minds (?)

'Anesthesia Can Dim Elderly Patients' Minds' or
Longitudinal Asssessment of Neurocognitive Function in Elderly Patient after Major, Noncardiac Surgery (pick your title):

""Conclusion: Elderly patients experience a high prevalence and persistence of cognitive decline after major, noncardiac surgery characterized by early improvement followed by a later decline. Cognitive impairment at hospital discharge predicts long-term cognitive impairment. Future investigations should evaluate the mechanisms responsible for postoperative cognitive decline and interventions to reduce this serious complication.""

The actual scientific abstract is here.

Though intriguing, it's only an abstract. There are so many confounding factors, it's really hard to know what to make of this on first blush. Where's the control group? Wouldn't it be better to have a control group that did NOT have surgery or anesthesia at all and see how they fared after two years?

[Via Yahoo! News: Health]



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