SSFNB or continuous FNB (plus PCA) was found to be superior to PCA alone for postoperative analgesia for patients having total knee arthroplasty. The impact of adding a sciatic block or continuous FNB to a SSFNB needs to be studied further.

Gabapentin 600 mg po given preoperatively followed by 200 mg po every eight hours for two days has no effect on postoperative morphine consumption, pain scores, patient satisfaction, or length of hospital stay. This trial is registered at ClinicalTrials.gov NCT01307202.

Eukaryotic chromosomes terminate in specialized structures, telomeres, that are necessary for their stability and function (for reviews, see references 7 and 61). Telomeres consist of a complex of G-rich repeated DNA and of sequence-specific DNA binding proteins (for a review, see reference 20). Formation of the complex and telomere function, therefore, have stringent DNA sequence requirements (TTAGGG in vertebrates [27,44]). Synthesis of telomeric DNA is catalyzed by telomerase, a ribonucleoprotein that utilizes a domain of its own RNA component as the template for de novo addition of nucleotides to the G-rich strand (25,26,43). This process compensates for the loss of terminal sequences occurring during semiconservative replication of linear DNA molecules (47,57) and is instrumental in keeping telomere length at an equilibrium (for a review, see reference 24).Over the last few years, experimental evidence has supported the presumed role of telomere maintenance in cell life span regulation, making telomerase an essential function for longterm or unlimited cell proliferation. Deletion of the template RNA gene, which is required for enzyme activity (26), results in progressive telomere shortening and in loss of viability of otherwise immortal yeast cells (41,52). Human somatic cells, which generally lack detectable levels of telomerase (for a review, see reference 31), undergo telomere erosion with cell division in vitro (3, 14, 28; for a review, see reference 5) and have a limited life span (29). Immortal germ line cells (33, 58) and the majority of somatic cells immortalized in vitro or in vivo, on the other hand, express telomerase and maintain their telomeres (14-16, 33, 35, 51; for reviews, see references 6 and 17). Experimental lengthening of telomeres (59) or inhibition of telomerase (21,46,53) in immortal human cells has been shown to prolong or reduce, respectively, cell proliferative capacity. Alterations in telomere structure that are independent of telomerase inhibition can also have an impact on cell growth and survival. Proteins that bind telomeric DNA are known to participate in telomere length regulation (20), and in yeast, mutation or deletion of these proteins destabilizes telomeres and impairs cell survival (36, 37). In addition, in both Tetrahymena thermophila and yeast, mutations of the template domain of the telomerase RNA and the consequent expression of a mutant enzyme cause loss of telomere length regulation and of cell viability (34,41,49,60).Experimental manipulation of telomeres in lower eukaryotes has also revealed alternative mechanisms for telomere maintenance that may utilize recombination with internal telomeric repeats or gene conversion at the chromosome termini to restore telomeric sequences (38,42,56). Survivors that maintain telomeres by these processes have been consistently rescued from populations of yeast lacking a telomeric protein or telomerase, or expressing a mutant enzyme, suggesting that recombination or gene conversion may operate as a salvage pathway when the norm...

This trial indicated that gabapentin treatment had no clinically important reduction in postoperative morphine consumption at 72 hr in patients undergoing THA. Multimodal analgesia may account for the similar primary and secondary outcomes found in the groups. This trial was registered at ClinicalTrials.gov, number: NCT01307202.

No abstract