Incisional pain dominated during the first two post-operative days after LC. Preoperative somato-visceral or somatic local anesthesia reduced incisional pain during the first three post-operative hours. A combination of somato-visceral local anesthetic treatment did not reduce intraabdominal pain, shoulder pain or nausea more than somatic treatment alone. Preoperative incisional infiltration of local anesthetics is recommended.

Solutions containing the components Au(+), dppe (dppe is bis(diphenylphosphino)ethane), and Br(-) in a 1:1:1 ratio can produce three different types of crystals: type A, orange luminescent solvates of the dimer Au(2)(dppe)(2)Br(2) (Au(2)(μ-dppe)(2)Br(2)·2(OSMe(2)), Au(2)(μ-dppe)(2)Br(2)·2(OCMe(2)), Au(2)(μ-dppe)(2)Br(2)·2(CH(2)Cl(2)), Au(2)(μ-dppe)(2)Br(2)·2(HC(O)NMe(2))); type B, green luminescent solvates of the same dimer (Au(2)(μ-dppe)(2)Br(2)·(NCMe) and Au(2)(μ-dppe)(2)Br(2)·0.5(C(4)H(10)O)); and type C, orange luminescent solvates of a polymer ({Au(μ-dppe)Br}(n)·0.5(C(4)H(10)O) and {Au(μ-dppe)Br}(n)·(CH(2)Cl(2))). Some crystals of types A are solvoluminescent. Exposure of type A crystals of Au(2)(μ-dppe)(2)Br(2)·2(OCMe(2)) or Au(2)(μ-dppe)(2)Br(2)·2(CH(2)Cl(2)) to air or vacuum results in the loss of the orange luminescence and the formation of new green luminescent crystals. Subsequent exposure of these crystals to acetone or dichloromethane vapor results in the reformation of crystals of type A. The dimeric complexes in crystals of types A and B are all centrosymmetric and share a common ring conformation. Within these dimers, the coordination geometry of each gold center is planar with a P(2)Br donor set. In other respects, the Au(2)(μ-dppe)(2)Br(2) molecule is remarkably flexible and behaves as a molecular accordion, whose dimensions depend upon the solvate content of a particular crystalline phase. In particular, the dimer Au(2)(μ-dppe)(2)Br(2) is able to accommodate Au···Au separations that range from 3.8479(3) to 3.0943(2) Å, and these variations along with alterations in the Au-Br distances and in the P-Au-P angles are the likely causes of the differences in the luminescence properties of these crystals.

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Background: Ketamine can enhance anesthetic and analgesic actions of a local anesthetic via a peripheral mechanism. The authors' goal was to determine whether or not ketamine added to ropivacaine in interscalene brachial plexus blockade prolongs postoperative analgesia. In addition, we wanted to determine the incidence of adverse-effects in patients undergoing hand surgery. Methods: Sixty adults scheduled for forearm or hand surgery under the interscalene brachial plexus block were prospectively randomized to receive one of the solutions of the study. Group P received 0.5% ropivacaine 30 ml, group K received 0.5% ropivacaine 30 ml with 30 mg ketamine, and group C received 0.5% ropivacaine with 30 mg ketamine i.v. Loss of shoulder abduction, elbow flexion, wrist flexion and loss of pinprick in the C4-7 sensory dermatomes were assessed at 1-min intervals. Adverseeffects were assessed every 5 min. The duration of the sensory and motor blocks was assessed after operation. Adverse-effects were also recorded. 821Results: The onset time of sensory or motor blockade and the duration of sensory or motor blockade were similar in all groups. Adverse-effects occurred in 44% of patients in group K and 94% of group C. Conclusion: This study suggests that 30 mg ketamine added to ropivacaine in the brachial plexus block does not improve the onset or duration of sensory block, but it does cause a relatively high incidence of adverse-effects. These two findings do not encourage the use of ketamine with local anesthetics for brachial plexus blockade.