Anesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
Cesarean delivery: a randomized trial of epidural versus patient-controlled meperidine analgesia during labor.
Reports indicate that the administration of epidural analgesia for pain relief during labor interferes with labor and increases cesarean deliveries. However, only a few controlled trials have assessed the effect of epidural analgesia on the incidence of cesarean delivery. The authors' primary purpose in this randomized study was to evaluate the effects of epidural analgesia on the rate of cesarean deliveries by providing a suitable alternative: patient-controlled intravenous analgesia. ⋯ Epidural analgesia was not associated with increased numbers of cesarean delivery when compared with a suitable alternative method of analgesia.
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Comparative Study
Prevention of methacholine-induced changes in respiratory mechanics in piglets: a comparison of sevoflurane and halothane.
Sevoflurane is a new volatile anesthetic agent that may be a useful alternative to halothane for anesthesia in children. However, there is insufficient information about its effects on respiratory mechanics, particularly in the presence of constrictor stimuli. ⋯ Sevoflurane and halothane can prevent methacholine-induced changes in lung function.
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Incomplete sensory blockade of the foot after sciatic nerve block in the popliteal fossa may be related to the motor response that was elicited when the block was performed. We investigated the appropriate motor response when a nerve stimulator is used in sciatic nerve block at the popliteal fossa. ⋯ Inversion is the motor response that best predicts complete sensory blockade of the foot. Incomplete blockade of the sciatic nerve may be a result of the size of the sciatic nerve, to separate fascial coverings of the tibial and common peroneal nerves, or to blockade of either the tibial or common peroneal nerves after branching from the sciatic nerve.
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Research has suggested that nitrous oxide may be harmful to ischemic neurons; however, the evidence for this is equivocal. The authors used rat hippocampal slices to examine the effects of nitrous oxide on neuronal hypoxic damage. ⋯ Nitrous oxide impaired electrophysiologic recovery of hippocampal slices after severe hypoxia. Nitrous oxide did not cause significant changes in the biochemical parameters examined.