Anesthesia and analgesia
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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.
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Anesthesia and analgesia · Nov 2006
Comparative StudyEducating anesthesiology residents to perform percutaneous cricothyrotomy, retrograde intubation, and fiberoptic bronchoscopy using preserved cadavers.
Experience with invasive airway procedures may be difficult to obtain during residency training, and anesthesiologists may therefore be hesitant to use these life-saving techniques. We designed a prospective study to determine whether using embalmed cadavers to teach percutaneous cricothyrotomy (PC), retrograde intubation (RI), and fiberoptic intubation to anesthesiology residents would improve their perceived procedural confidence and ability. After demonstration of these techniques by experienced attending physicians, residents were allowed to practice, with instructor guidance, on the cadavers. ⋯ Likewise, the number of residents who reported they would use RI increased from 6% to 67% (P
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Anesthesia and analgesia · Nov 2006
Comparative StudyPerioperative complications of adenotonsillectomy in children with obstructive sleep apnea syndrome.
We evaluated the rate of complications experienced by children who undergo adenotonsillectomy for obstructive sleep apnea syndrome (OSAS), the safety of a standard anesthetic protocol for these children, and preoperative predictors of complications. Sixty-one children with OSAS, confirmed by polysomnography, and 21 children with recurrent tonsillitis were anesthetized using a standard protocol before adenotonsillectomy (ages 2-16 yr, ASA 1-3). The number of complications and medical interventions in the perioperative period were recorded and correlated with the presence and severity of OSAS. ⋯ Medical intervention was necessary in more children with OSAS during recovery and emergence than in the non-OSAS group (17/61 vs 1/21, P < 0.05). Both groups of children had similar opioid requirements and time to discharge from the recovery room. These findings suggest that children with OSAS are at risk for respiratory complications after adenotonsillectomy, but that these complications do not prolong the time to discharge.
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Anesthesia and analgesia · Nov 2006
Comparative StudyThe effects of dexmedetomidine/remifentanil and midazolam/remifentanil on auditory-evoked potentials and electroencephalogram at light-to-moderate sedation levels in healthy subjects.
Avoidance of excessively deep sedation levels is problematic in intensive care patients. Electrophysiologic monitoring may offer an approach to solving this problem. Since electroencephalogram (EEG) responses to different sedation regimens vary, we assessed electrophysiologic responses to two sedative drug regimens in 10 healthy volunteers. ⋯ We conclude that ERPs in volunteers sedated with dex/remi, in contrast to mida/remi, indicate a cortical response to acoustic stimuli, even when sedation reaches deeper levels. Consequently, ERP can monitor sedation with midazolam but not with dexmedetomidine. The reverse is true for BIS.