Anesthesiology
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Randomized Controlled Trial Comparative Study
Fiberoptic oral intubation: the effect of model fidelity on training for transfer to patient care.
Previous studies have indicated that fiberoptic orotracheal intubation (FOI) skills can be learned outside the operating room. The purpose of this study was to determine which of two educational interventions allows learners to gain greater capacity for performing the procedure. ⋯ There was no added benefit from training on a costly virtual reality model with respect to transfer of FOI skills to intraoperative patient care. Second attempts in both groups were significantly better than first attempts. Low-fidelity models for FOI training outside the operating room are an alternative for programs with budgetary constraints.
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Randomized Controlled Trial Multicenter Study Comparative Study
Phase 2, double-blind, placebo-controlled, dose-response trial of intravenous adenosine for perioperative analgesia.
Adenosine regulates pain transmission by actions at spinal, supraspinal, and peripheral sites. A few studies have suggested that administration of adenosine might be associated with anesthetic- and analgesic-sparing effects. The primary aim of this multicenter study was to determine the dose-response profile of adenosine with respect to perioperative analgesia. ⋯ There were no differences between placebo and adenosine with respect to efficacy and safety for perioperative analgesia.
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Randomized Controlled Trial Comparative Study
Thoracic epidural analgesia with low concentration of bupivacaine induces thoracic and lumbar sympathetic block: a randomized, double-blind clinical trial.
Clinical benefits of thoracic epidural anesthesia (TEA) are partly ascribed to thoracic sympathetic block. However, data regarding sympathetic activity during TEA are scarce and contradictory. This prospective, randomized, double-blind study evaluated the segmental propagation of sympathetic block after low-concentration, high-volume TEA using digital thermography. ⋯ TEA with 10 ml bupivacaine, 0.25%, induced thoracic and lumbar sympathetic block that precedes and exceeds sensory block. Caudal limit of sympathetic block could not be demonstrated in this study.
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Randomized Controlled Trial Comparative Study
Electroencephalographic order pattern analysis for the separation of consciousness and unconsciousness: an analysis of approximate entropy, permutation entropy, recurrence rate, and phase coupling of order recurrence plots.
Nonlinear electroencephalographic parameters, e.g., approximate entropy, have been suggested as measures of the hypnotic component of anesthesia. Compared with linear methods, they may detect additional information and quantify the irregularity of a dynamical system. High dimensionality of a signal and disturbances may affect these parameters and change their ability to distinguish consciousness from unconsciousness. Methods of order pattern analysis, in this investigation represented by permutation entropy, recurrence rate, and phase coupling of order recurrence plots, are suitable for any type of time series, whether deterministic or noisy. They may provide a better estimation of the hypnotic component of anesthesia than other nonlinear parameters. ⋯ Parameters of the nonlinear method order pattern analysis separate consciousness from unconsciousness and are grossly independent of high-frequency components of the electroencephalogram.