Anesthesiology
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Randomized Controlled Trial Clinical Trial
Management of bladder function after outpatient surgery.
This study was designed to test a treatment algorithm for management of bladder function after outpatient general or local anesthesia. ⋯ In reliable patients at low risk for retention, voiding before discharge appears unnecessary. In high-risk patients, continued observation until the bladder is emptied is indicated to avoid prolonged overdistention of the bladder.
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Randomized Controlled Trial Comparative Study Clinical Trial
Ultrasound-guided internal jugular venous cannulation in infants: a prospective comparison with the traditional palpation method.
Percutaneous cannulation of the internal jugular vein in infants is technically more difficult and carries a higher risk of carotid artery puncture than in older children and adults. In this prospective study, the authors tested their hypothesis that using an ultrasound scanner would increase the success of internal jugular cannulation and decrease the incidence of carotid artery puncture in infants. ⋯ Ultrasonographic localization of the internal jugular vein was superior to the landmarks technique in terms of overall success, speed, and decreased incidence of carotid artery puncture.
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Randomized Controlled Trial Clinical Trial
Rapid tracheal intubation with rocuronium: a probability approach to determining dose.
Rapid tracheal intubation with rocuronium has not been studied using a probability-based approach. The authors aimed to predict doses of rocuronium giving 90% and 95% probability of in intubation within 60 s and to estimate their durations of action. ⋯ After induction with fentanyl and propofol, rocuronium, 1.04 mg/kg gives 95% probability of successful intubation at 60 s.
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Randomized Controlled Trial Clinical Trial
Sevoflurane increases lumbar cerebrospinal fluid pressure in normocapnic patients undergoing transsphenoidal hypophysectomy.
The data on the effect of sevoflurane on intracranial pressure in humans are still limited and inconclusive. The authors hypothesized that sevoflurane would increase intracranial pressure as compared to propofoL METHODS: In 20 patients with no evidence of mass effect undergoing transsphenoidal hypophysectomy, anesthesia was induced with intravenous fentanyl and propofol and maintained with 70% nitrous oxide in oxygen and a continuous propofol infusion, 100 microg x kg(-1) x min(-1). The authors assigned patients to two groups randomized to receive only continued propofol infusion (n = 10) or sevoflurane (n = 10) for 20 min. During the 20-min study period, each patient in the sevoflurane group received, in random order, two concentrations (0.5 times the minimum alveolar concentration [MAC] and 1.0 MAC end-tidal) of sevoflurane for 10 min each. The authors continuously monitored lumbar cerebrospinal fluid (CSF) pressure, blood pressure, heart rate, and anesthetic concentrations. ⋯ Sevoflurane, at 0.5 and 1.0 MAC, increases lumbar CSF pressure. The changes produced by 1.0 MAC sevoflurane did not differ from those observed in a previous study with 1.0 MAC isoflurane or desflurane.