A continuous infusion of bupivacaine 0.5% at 4 ml/h is effective for decreasing pain and the need for opioid analgesic medication as well as for improving patient satisfaction with their pain management after cardiac surgery. Patients in the bupivacaine-0.5% group were able to ambulate earlier, leading to a reduced length of hospital stay.

The ReliefBand compared favorably to ondansetron (4 mg intravenously) when used for prophylaxis against postoperative nausea and vomiting. Furthermore, the acustimulation device enhanced the antiemetic efficacy of ondansetron after plastic surgery.

The growth and maintenance of dendritic form is dependent on normally functioning excitatory afferents. We have now examined the development of dendritic arbors in the gerbil lateral superior olive (LSO), following contralateral cochlear removal at postnatal day 7, a manipulation that substantially eliminates driven inhibitory transmission. Previous studies have demonstrated that the morphology of LSO dendritic arbors varies with tonotopic position and becomes more restricted with age. The presumed decrease of inhibitory transmission in the contralateral LSO resulted in a hypertrophic response. Quantification of Golgi-impregnated neurons revealed that dendrites had a significantly greater number of branch points, and their arbors were more spread out along the frequency axis compared to normal. This was especially apparent in the high frequency projection region where the glycine receptor density is known to be 4-fold higher than in the low frequency projection region. A measure of LSO nucleus size, cross-sectional area, was identical to control values, indicating no overt signs of degenerative phenomena. Cochlear ablation resulted in a significant atrophy of the ipsilateral LSO, with significant effects on dendritic structure. We conclude that decreased inhibitory transmission during development does not lead to a net degenerative response. Rather, the postsynaptic neurons exhibit a hypertrophic phenotype that may be due to the persistence of an immature state. These results indicate that activity-dependent morphogenetic events are a consequence of both excitatory and inhibitory synaptic transmission.

The authors conclude that the adjunctive use of 4 mg intravenous dexamethasone shortened the time to achieve discharge criteria and improved the quality of recovery and patient satisfaction scores after laparoscopic cholecystectomy procedures in outpatients receiving prophylaxis with 12.5 mg intravenous dolasetron.

Acustimulation with the ReliefBand can be used as an alternative to ondansetron for the treatment of established PONV. However, the use of ondansetron (4 mg intravenously) in combination with the ReliefBand device improved the complete response rate to the acustimulation therapy.