Anesthesia and analgesia
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Anesthesia and analgesia · Mar 2007
Randomized Controlled TrialIntrathecal anesthesia for elderly patients undergoing short transurethral procedures: a dose-finding study.
One hundred elderly men (> or =65 yr) undergoing transurethral procedures (<45 min) received bupivacaine 7.5 mg, or bupivacaine 5 mg + fentanyl 20 mug, or bupivacaine 4 mg + fentanyl 20 mug, or bupivacaine 3 mg + fentanyl 20 mug, intrathecally. Intraoperative "rescue" fentanyl requirements were higher (P < 0.03) in group bupivacaine 3 mg + fentanyl. Times (min) to ambulation eligibility were decreased in a dose-dependant manner (157 +/- 50 vs 147 +/- 37 vs 128 +/- 40 vs 116 +/- 29, respectively). Of the techniques studied, intrathecal bupivacaine 4 mg + fentanyl 20 mug provided adequate analgesia and was associated with hemodynamic stability and a favorable recovery profile.
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Anesthesia and analgesia · Mar 2007
Randomized Controlled TrialProphylactic [corrected] granisetron does not prevent postdelivery nausea and vomiting during elective cesarean delivery under spinal anesthesia.
Intraoperative nausea and vomiting (IONV) during cesarean delivery (CD) under regional anesthesia has multiple etiologies, and the role of prophylactic antiemetics for prevention of IONV remains controversial. In this trial we sought to determine the efficacy of granisetron for prevention of IONV during elective CD under spinal anesthesia with strict control of the causative factors. ⋯ Despite strict control of the causative factors, IONV still affects 18% of patients undergoing elective CD, and prophylactic granisetron 1 mg is ineffective under the studied circumstances.
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Anesthesia and analgesia · Mar 2007
Perioperative complications in children with pulmonary hypertension undergoing noncardiac surgery or cardiac catheterization.
Pulmonary arterial hypertension (PAH) can lead to significant cardiac dysfunction and is considered to be associated with an increased risk of perioperative cardiovascular complications. ⋯ Children with suprasystemic PAH have a significant risk of major perioperative complications, including cardiac arrest and pulmonary hypertensive crisis.
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Anesthesia and analgesia · Mar 2007
Clinical TrialThe accuracy of the oxygen washout technique for functional residual capacity assessment during spontaneous breathing.
Measurement of functional residual capacity (FRC) is of considerable interest for monitoring patients with lung injury. The lack of instruments has impeded routine bedside FRC measurement. Recently, a simple automated method for FRC assessment by O2 washout has been introduced. We designed this study to evaluate the accuracy of FRC measurement using the O2 washout technique. ⋯ The bias and precision of the O2 washout technique using the LUFU system were clinically acceptable when compared with FRC-He and FRC-bp for FRC assessment in spontaneously breathing volunteers.
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High endotracheal cuff pressures have been shown to cause high mucosal pressures and a reduction in mucosal blood flow, with the risk of mucosal ischemia. We aimed to directly measure the pressure exerted by the bronchial cuffs of double-lumen tubes (DLT) and by the cuffs of three new designs of endobronchial blocker (EBB). ⋯ A transmitted pressure <30 mm Hg has been recommended to avoid mucosal injury. Our study shows that at clinically relevant cuff volumes, the pressures exerted by the cuffs do not exceed the recommended safe limit.