Anesthesiology
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Randomized Controlled Trial Clinical Trial
Clevidipine in adult cardiac surgical patients: a dose-finding study.
Treatment of elevated blood pressure is frequently necessary after cardiac surgery to minimize postoperative bleeding and to attenuate afterload changes associated with hypertension. The purpose of this study was to investigate the pharmacodynamics and pharmacokinetics of a short-acting calcium channel antagonist, clevidipine, in the treatment of hypertension in postoperative cardiac surgical patients. ⋯ Clevidipine is a calcium channel antagonist with a very short duration of action that effectively decreases systemic vascular resistance and mean arterial pressure without changing heart rate, cardiac index, or cardiac filling pressures.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects of clonidine on postoperative nausea and vomiting in breast cancer surgery.
Postoperative nausea and vomiting (PONV) is still common, especially among female patients. Our hypothesis is that coinduction with clonidine reduces the incidence of PONV in adult patients undergoing breast cancer surgery. ⋯ Coinduction with clonidine significantly increased the number of PONV-free patients after breast cancer surgery with general anesthesia.
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Multicenter Study
What sample sizes are required for pooling surgical case durations among facilities to decrease the incidence of procedures with little historical data?
Better predictions of each case's duration would reduce operating room labor costs and patient waiting times. A barrier to using historical case duration data to predict the duration of future cases is the absence for some cases of previous data for the same scheduled procedure from the same facility. The authors examined sample size requirements for pooling case duration data from several facilities to create a 90% chance of having case duration data for almost all procedures. ⋯ The lack of historical case duration data for scheduled procedures is an important cause of inaccuracy in predicting case durations. However, millions of cases probably would be required to provide historical case duration data for almost all procedures.
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Randomized Controlled Trial Clinical Trial
The influence of hyperoxic ventilation during sodium nitroprusside-induced hypotension on skeletal muscle tissue oxygen tension.
Increasing inspired oxygen concentrations might provide a simple and effective intervention to increase oxygen tension in tissues during controlled hypotension. To test this hypothesis, the influence of hyperoxic ventilation (100% O2) on skeletal muscle oxygen partial pressure (Ptio2) in patients receiving sodium nitroprusside-induced controlled hypotension was studied. ⋯ Hyperoxic ventilation improved skeletal muscle tissue oxygenation during sodium nitroprusside-induced hypotension. This improved local tissue oxygenation seems to be most likely due to an increase in convective oxygen transport and the attenuation of hyperoxemia-induced arteriolar vasoconstriction by sodium nitroprusside.