Anesthesia and analgesia
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Anesthesia and analgesia · Nov 2006
Randomized Controlled Trial Comparative StudyAirway responses during desflurane versus sevoflurane administration via a laryngeal mask airway in smokers.
Cigarette smokers have a greater risk of respiratory complications during anesthesia compared with nonsmokers. It is not known whether the relative pungency of an inhaled anesthetic further contributes to the smokers' increased rate of such complications. In the present study, we tested whether the use of a more pungent anesthetic (desflurane) would result in a higher rate of coughing, breath holding, laryngospasm, or desaturation among patients who smoke. ⋯ Most coughing occurred during induction (33%) or emergence (56%), in the setting of airway manipulation and low anesthetic concentration. The rate of breath holding, laryngospasm, and desaturation was similar between those receiving desflurane versus sevoflurane. A retrospective comparison of this cohort of 110 smokers to a previous group consisting of 100 nonsmokers and 27 smokers receiving an identical anesthetic regimen indicates that cigarette smoking, but not choice of anesthetic, places patients at increased risk of respiratory complications.
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Anesthesia and analgesia · Nov 2006
ReviewThe problem of artifacts in patient monitor data during surgery: a clinical and methodological review.
Artifacts are a significant problem affecting the accurate display of information during surgery. They are also a source of false alarms. A secondary problem is the inadvertent recording of artifactual and inaccurate information in automated record keeping systems. ⋯ Methods adopted by currently marketed patient monitors to eliminate and minimize artifacts due to technical and environmental factors are reviewed and discussed. Also discussed are promising artifact detection and correction methods that are being investigated. These might be used to detect and eliminate artifacts with improved accuracy and specificity.
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Anesthesia and analgesia · Nov 2006
Randomized Controlled Trial Comparative StudyDoes cerebral monitoring improve ophthalmic surgical operating conditions during propofol-induced sedation?
Sudden movements from over-sedation during ophthalmic surgery can be detrimental to the eye. Bispectral index (BIS) and middle-latency auditory-evoked potentials (Alaris AEP index, AAI) were reported to be accurate indicators for the level of sedation and loss of consciousness. We assessed these monitors during sedation with special emphasis on preventing over-sedation. ⋯ BIS was out of range 7% of the time vs 58% for AAI. No significant differences in treatment quality were observed among the four groups. We conclude that propofol sedation, guided by BIS or AAI monitoring, did not enhance ophthalmic surgical operating conditions over sedation guided by clinical observation only.
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Anesthesia and analgesia · Nov 2006
Randomized Controlled Trial Comparative StudyThe twenty-degree reverse-Trendelenburg position decreases the incidence and severity of postoperative nausea and vomiting after thyroid surgery.
In this randomized, single-blind, controlled study, we evaluated whether the 20 degrees reverse-Trendelenburg position had an effect on postoperative nausea and vomiting in patients undergoing thyroid surgery. ⋯ The 20 degrees reverse-Trendelenburg position effectively ameliorates postoperative nausea and/or vomiting.
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Anesthesia and analgesia · Nov 2006
Comparative StudyExperimental heat pain for detecting pregnancy-induced analgesia in humans.
Animal studies suggest that increased circulating estrogen and progesterone, and activation of the endorphin system cause prenancy-induced antinociceptive effects. Human studies have provided inconsistent results and have often lacked a nonpregnant control group. In this study, we compared sensitivity to experimental heat and cold pain in pregnant and nonpregnant women. ⋯ Pregnancy-induced analgesic effects at term can be detected in a model of experimental heat pain. These effects persist during the first 24-48 h after delivery. Experimental heat pain is a suitable modality for further characterizing the phenomenon of pregnancy-induced analgesia in humans.