Running to stand still: late modernity's acceleration fixation

That we live in a time of unprecedented and ever-increasing change is both a shibboleth of our age and the more-or-less explicit justification for all manner of “strategic” actions. The seldom, if ever, questioned assumption is that our now is more ephemeral, more evanescent, than any that preceded it. In this essay, we subject this assumption to some critical scrutiny, utilizing a range of empirical detail. In the face of this assay we find the assumption to be considerably wanting. We suggest that what we are actually witnessing is mere acceleration, which we distinguish as intensification along a preexisting trajectory, parading as more substantive and radical movement away from a preexisting trajectory. Deploying Deleuze's (2004) terms we are, we suggest, in thrall to representation of the same at the expense of repetition of difference. Our consumption by acceleration, we argue, both occludes the lack of substantive change actually occurring while simultaneously delimiting possibilities of thinking of and enacting the truly radical. We also consider how this setup is maintained, thus attempting to shed some light on why we are seemingly running to stand still. As the Red Queen said, “it's necessary to run faster even to stay in the one place.”

Postoperative analgesic effect, of preoperatively administered dexamethasone, after operative fixation of fractured neck of femur: randomised, double blinded controlled study.

Background: Fractured neck of femur is a common cause of hospital admission in the elderly and usually requires operative fixation. In a variety of clinical settings, preoperative glucocorticoid administration has improved analgesia and decreased opioid consumption. Our objective was to define the postoperative analgesic efficacy of single dose of dexamethasone administered preoperatively in patients undergoing operative fixation of fractured neck of femur. Methods: Institutional ethical approval was granted and written informed consent was obtained from each patient. Patients awaiting for surgery at Cork University Hospital were recruited between July 2009 and August 2012. Participating patients, scheduled for surgery were randomly allocated to one of two groups (Dexamethasone or Placebo). Patients in the dexamethasone group received a single dose of intravenous dexamethasone 0.1 mg kg -1 immediately preoperatively. Patients in the placebo group received the same volume of normal saline. Patients underwent operative fixation of fractured neck of femur using standardised spinal anaesthesia and surgical techniques. The primary outcome was pain scores at rest 6 h after the surgery. Results: Thirty seven patients were recruited and data from thirty patients were analysed. The groups were similar in terms of patient characteristics. Pain scores at rest 6 h after the surgery (the principal outcome) were lesser in the dexamethasone group compared with the placebo group [0.8(1.3) vs. 3.9(2.9), mean(SD) p = 0.0004]. Cumulative morphine consumption 24 h after the surgery was also lesser in the dexamethasone group [7.7(8.3) vs. 15.1(9.4), mean(SD) mg, p = 0.04]. Conclusions: A single dose of intravenous dexamethasone 0.1 mg kg -1 administered before operative fixation of fractured neck of femur improve significantly the early postoperative analgesia. Trial registration: ClinicalTrials.gov identifier: NCT01550146, date of registration: 07/03/2012