Anesthesia and analgesia
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Anesthesia and analgesia · Sep 2004
Case ReportsSequential one-lung isolation using a double arndt bronchial blocker technique.
One-lung ventilation and isolation can be performed using a double-lumen endotracheal tube or one of several alternative airway devices. We report a case in which sequential lung isolation was performed by placing two Arndt bronchial blockers through a single-lumen endotracheal tube. Traditional double-lumen tubes can be difficult to place and have potential complications that may be avoided by placing two Arndt blockers.
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Anesthesia and analgesia · Sep 2004
ReviewPatients' global evaluation of analgesia and safety of injected parecoxib for postoperative pain: a quantitative systematic review.
Parecoxib is the only parenterally administered cyclooxygenase-2-selective inhibitor available. We performed a systematic review, including full reports of randomized comparisons of parecoxib compared with any other analgesic intervention for prophylaxis or treatment of postoperative pain. Dichotomous data on patients' global evaluation of their analgesic regimen were extracted by means of the fraction of patients who rated their medication as "good" or "excellent." For safety analysis, data on any reported adverse effects were extracted. ⋯ Overall adverse effects for parecoxib 20 and 40 mg were not different from those with placebo, morphine, or ketorolac. These results suggest a favorable profile for parecoxib compared with inactive or active controls. The optimal dose, timing, and frequency of administration need to be determined.
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Anesthesia and analgesia · Sep 2004
The effect of lengthening anesthesiology residency on subspecialty education.
In this study, we sought to determine the long-term effect of the additional year of anesthesia residency (postgraduate year [PGY]-4) instituted in 1989 by the American Board of Anesthesiology on the number of individuals who pursued 12-mo subspecialty anesthesia training. We tested the hypothesis that extending education by a year would decrease the number of anesthesia subspecialty trainees. Surveys were collected from approved anesthesia residency training programs in the United States from 1989 to 2001. ⋯ The largest declines occurred in critical care medicine and research. Our data do not indicate a decrease in the number of anesthesiology subspecialists. Factors other than the duration of training appear responsible for the selection of subspecialty education.
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Anesthesia and analgesia · Sep 2004
Case ReportsKetamine for long-term sedation and analgesia of a burn patient.
We present a case in which ketamine was used for long-term sedation and analgesia of a burn patient. Under escalating opiate dosages, the patient had developed persistent ileus as well as abdominal distension that caused respiratory compromise, without receiving sufficient analgesia. ⋯ The quality of sedation also changed favorably. There were no obvious adverse effects of ketamine.
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Anesthesia and analgesia · Sep 2004
The effect of insulin on the resuscitation of bupivacaine-induced severe cardiovascular toxicity in dogs.
Resuscitation after bupivacaine-induced cardiovascular collapse is difficult and often resistant to conventional treatment. We tested the hypothesis that insulin treatment would effectively reverse bupivacaine-induced cardiovascular collapse in pentobarbital-anesthetized dogs. Bupivacaine was administered at 0.5 mg. kg(-1). min(-1) until mean arterial blood pressure decreased to 40 mm Hg or less. ⋯ In contrast to the control group, all IGK dogs survived. Mean arterial blood pressure, heart rate, cardiac output, mixed venous oxygen saturation, and end tidal CO(2) recovered toward baseline levels in the IGK group. In conclusion, severe bupivacaine-induced cardiovascular collapse in dogs was effectively reversed with the insulin treatment.