Anesthesiology
-
Randomized Controlled Trial Clinical Trial
ED50 and ED95 of intrathecal hyperbaric bupivacaine coadministered with opioids for cesarean delivery.
Successful cesarean delivery anesthesia has been reported with use of small doses (5-9 mg) of intrathecal bupivacaine coadministered with opioids. This double-blind, randomized, dose-ranging study determined the ED50 and ED95 of intrathecal bupivacaine (with adjuvant opioids) for cesarean delivery anesthesia. ⋯ The ED95 of intrathecal bupivacaine under the conditions of this study is considerably in excess of the low doses proposed for cesarean delivery in some recent publications. When doses of intrathecal bupivacaine less than the ED95, particularly near the ED50, are used, the doses should be administered as part of a catheter-based technique.
-
Randomized Controlled Trial Clinical Trial
Variable ventilation improves perioperative lung function in patients undergoing abdominal aortic aneurysmectomy.
Optimizing perioperative mechanical ventilation remains a significant clinical challenge. Experimental models indicate that "noisy" or variable ventilation (VV)--return of physiologic variability to respiratory rate and tidal volume--improves lung function compared with monotonous control mode ventilation (CV). VV was compared with CV in patients undergoing abdominal aortic aneurysmectomy, a patient group known to be at risk of deteriorating lung function perioperatively. ⋯ The VV mode of ventilation significantly improved lung function over CV in patients undergoing abdominal aortic aneurysmectomy.