Anesthesiology
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Randomized Controlled Trial Clinical Trial
Clonidine and ketanserin both are effective treatment for postanesthetic shivering.
Although meperidine is an effective treatment of postanesthetic shivering, its mechanism of action remains unknown. Investigation of other drugs might help clarify the mechanisms by which shivering can be controlled. Accordingly, we investigated the efficacy of clonidine, an alpha 2-adrenergic agonist, and ketanserin, a 5-hydroxytryptamine antagonist, in treating postanesthetic shivering. ⋯ Clonidine (150 micrograms) and ketanserin (10 mg) both are effective treatment for postanesthetic shivering. The effect of clonidine on shivering is dose-dependent: whereas 37.5 micrograms had no effect, 75 micrograms clonidine stopped shivering within 5 min.
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Randomized Controlled Trial Comparative Study Clinical Trial
The esophageal detector device. Does it work?
The esophageal detector device (EDD) is a diagnostic tool for confirmation of tracheal intubation. Capnography is the accepted standard for such confirmation. The purpose of this investigation was to determine whether results using the EDD and capnography agree. ⋯ The EDD is a valuable diagnostic technique for confirming tracheal intubation. Results using EDD agree with results using capnography; in 6% of instances there is a slow reinflation; and where there is no capnography, such as on hospital wards, EDD may be a useful diagnostic tool.
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Randomized Controlled Trial Clinical Trial
Prevention of intraoperative hypothermia by preoperative skin-surface warming.
Intraoperative hypothermia initially results from internal redistribution of heat facilitated by anesthesia-induced vasodilation. Preinduction skin-surface warming minimizes postinduction hypothermia in anesthetized volunteers. However, its efficacy might be reduced in surgical situations, because of multiple sources of heat loss. ⋯ Preanesthetic skin-surface warming reduces the initial postinduction hypothermia in surgical patients, preventing intraoperative hypothermia and postoperative shivering even for procedures lasting 3 h or longer.
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Randomized Controlled Trial Clinical Trial
Dose-response pharmacology of intrathecal morphine in human volunteers.
Intrathecal morphine sulfate (ITMS) administration was introduced into clinical practice in 1979. Inadequate information exists delineating ITMS respiratory effects in the dosage range most frequently employed today. This study evaluated 0.2, 0.4, and 0.6 mg ITMS in male volunteers. ⋯ ITMS produced dose-related analgesia and respiratory depression in nonsurgical healthy, young, adult male volunteers. Respiratory depression was significant after 0.2 or 0.4 mg and profound and prolonged after 0.6 mg. No clinical signs or symptoms, including respiratory rate, reliably indicated hypoxemia. Pulse oximetry reliably detected hypoxemia after ITMS, and supplemental nasal oxygen (2 L/min) effectively corrected this hypoxemia.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Intramuscular dexmedetomidine as premedication for general anesthesia. A comparative multicenter study.
Dexmedetomidine is a new potent and selective alpha 2-agonist that might prove useful as a preanesthetic agent. ⋯ The results suggest that pretreatment with a single intramuscular injection of 2.5 micrograms/kg dexmedetomidine is efficacious, but significantly increases the incidence of intraoperative hypotension and bradycardia in ASA physical status 1 or 2 patients.