Anesthesiology
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Preterm and ex-preterm infants are at risk for life-threatening apnea after general anesthesia. The authors attempted to define the postconceptual age beyond which apnea is less likely to occur and to identify the factors that predispose to postanesthetic apnea. ⋯ Ex-preterm infants younger than 44 weeks postconceptual age are at greater risk for apnea after general anesthesia than are infants older than 44 weeks postconceptual age. Based on these results, the maximum long-run risk of postanesthetic apnea in preterm infants older than 44 weeks postconceptual age is 5% with 95% confidence.
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Randomized Controlled Trial Clinical Trial
Intrathecal sufentanil for labor analgesia. Effects of added epinephrine.
Intrathecal sufentanil has been found to provide profound analgesia during labor. Epinephrine, when added to various local anesthetic agents or opioids, may modify the analgesic profile and incidence of side effects. The authors sought to determine the effect of adding 0.2 mg epinephrine to 10 micrograms sufentanil when administered for analgesia during labor. ⋯ Intrathecal sufentanil 10 micrograms, both with and without epinephrine, provided rapid-onset, albeit short-duration, analgesia during labor. Epinephrine did not prolong the duration of intrathecal sufentanil analgesia. The addition of epinephrine increased the incidence of nausea and decreased the incidence and severity of pruritus.
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Randomized Controlled Trial Clinical Trial
Isoflurane minimum alveolar concentration reduction by fentanyl.
Isoflurane is commonly combined with fentanyl during anesthesia. Because of hysteresis between plasma and effect site, bolus administration of fentanyl does not accurately describe the interaction between these drugs. The purpose of this study was to determine the MAC reduction of isoflurane by fentanyl when both drugs had reached steady biophase concentrations. ⋯ Defining the MAC reduction of isoflurane by all the opioids allows their more rational administration with inhalational anesthetics and provides a comparison of their relative anesthetic potencies.
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Randomized Controlled Trial Clinical Trial
The effectiveness of pressure support ventilation for mechanical ventilatory support in children.
The rapid respiratory frequency of children may lead to patient-ventilator asynchrony and increase the work of breathing during mechanical ventilation, and the use of a small endotracheal tube and a demand valve can further increase this work of breathing. Although pressure support ventilation (PSV) is well known to reduce the work of breathing in adults, there are no reports regarding clinical studies of PSV in children. Therefore, the effect of PSV on breathing patterns and the work of breathing in children was studied. ⋯ It was concluded that PSV can effectively augment spontaneous breathing and reduce the work of breathing in children.