Anesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
Effect of intraoperative fluid management on outcome after intraabdominal surgery.
The debate over the correct perioperative fluid management is unresolved. ⋯ In patients undergoing elective intraabdominal surgery, intraoperative use of restrictive fluid management may be advantageous because it reduces postoperative morbidity and shortens hospital stay.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparative study of sequential epidural bolus technique and continuous epidural infusion.
In this randomized, double-blind study, the authors compared the effectiveness of a sequential epidural bolus (SEB) technique versus a standard continuous epidural infusion (CEI) technique of local anesthetic delivery. Both techniques used the same hourly dose of local anesthetic. ⋯ The SEB technique with ropivacaine provides superior epidural block compared with an identical hourly dose administered as a continuous infusion.
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Review Practice Guideline Guideline
Practice advisory for the perioperative management of patients with cardiac rhythm management devices: pacemakers and implantable cardioverter-defibrillators: a report by the American Society of Anesthesiologists Task Force on Perioperative Management of Patients with Cardiac Rhythm Management Devices.
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Comparative Study
Sex- and age-related differences in morphine requirements for postoperative pain relief.
Sex-related differences in the perception of pain and susceptibility to opioids remain a matter of debate. Intravenous morphine titration used to obtain pain relief in the immediate postoperative period is a unique clinical model for assessing the effect of sex on reported pain. Because of the wide variation in dose requirements for pain management, the authors conducted a prospective study in a large population and also assessed the effect of aging. ⋯ Women experienced more severe postoperative pain and required a greater dose (+11%) of morphine than men in the immediate postoperative period. This sex-related difference disappeared in elderly patients.
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Comparative Study
Management of the difficult airway: a closed claims analysis.
The purpose of this study was to identify the patterns of liability associated with malpractice claims arising from management of the difficult airway. ⋯ Death/BD in claims from difficult airway management associated with induction of anesthesia but not other phases of anesthesia decreased in 1993-1999 compared with 1985-1992. Development of additional management strategies for difficult airways encountered during maintenance, emergence, or recovery from anesthesia may improve patient safety.