Anesthesiology
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Randomized Controlled Trial Clinical Trial Retracted Publication
Blood conservation techniques and platelet function in cardiac surgery.
Postoperative alterations in platelet function induced by cardiopulmonary bypass (CPB) are of importance. The effect on platelet aggregation of three different techniques for reducing blood consumption was studied in 30 patients undergoing elective aortocoronary bypass grafting from the beginning of anesthesia until the 1st postoperative day. The patients were randomly divided into three groups, in which 1) a cell separator was used during and after CPB; 2) a hemofiltration device was used; and 3) high-dose aprotinin was used in order to reduce the need of homologous blood. ⋯ On the 1st postoperative day, platelet aggregation in the hemofiltration patients and the patients treated with aprotinin had normalized. Aggregation of patients pretreated with high-dose aprotinin was not different from that of the hemofiltration patients throughout the investigation. Blood loss was significantly highest in the cell-separator group (770 +/- 400 ml on the 1st postoperative day) but was not different between the hemofiltration (390 +/- 230 ml) and the aprotinin-treated patients (260 +/- 160 ml).(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Comparative Study Clinical Trial
Use of desflurane for outpatient anesthesia. A comparison with propofol and nitrous oxide.
Desflurane's induction and recovery characteristics were compared to those of propofol-nitrous oxide in outpatients undergoing laparoscopic procedures. Ninety-two healthy patients were randomized to receive either: 1) propofol induction and propofol-nitrous oxide maintenance (control), 2) propofol induction and desflurane-nitrous oxide maintenance, 3) desflurane-nitrous oxide, or 4) desflurane alone for induction and maintenance of anesthesia. Inhalation induction with desflurane-nitrous oxide was faster than with desflurane alone (100 +/- 35 vs. 124 +/- 43 s). ⋯ In conclusion, induction of anesthesia with desflurane was rapid but is associated with a high incidence of airway irritation. Emergence and recovery profiles after maintenance of anesthesia with desflurane compared favorably to a propofol-nitrous oxide combination. However, propofol was associated with a lower incidence of nausea than was desflurane after outpatient anesthesia for laparoscopic surgery.
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Comparative Study
Dose-response for atropine and heart rate in infants and children anesthetized with halothane and nitrous oxide.
The dose recommendations for atropine in anesthetized children vary, and the dose-response for heart rate has not been defined. We determined the dose-response for atropine and heart rate in 181 healthy children anesthetized with halothane and nitrous oxide. After induction of anesthesia, atropine in a dose of 5, 10, 20, 30, or 40 micrograms.kg-1 was administered by rapid intravenous infusion of each subject. ⋯ Subjects less than 6 months old had higher control and peak heart rates than did subjects greater than or equal to 2 yr old, but the older subjects had greater change in heart rate after atropine. For subjects greater than or equal to 2 yr old, all doses of atropine produced a significant increase in heart rate. The same was true for younger subjects, less than 6 months old, except that 5 micrograms.kg-1 did not increase heart rate.(ABSTRACT TRUNCATED AT 250 WORDS)