Anesthesia and analgesia
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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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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.
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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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Anesthesia and analgesia · Mar 2007
A survey of the use of ultrasound during central venous catheterization.
Complications during central venous catheterization (CVC) are not rare and can be serious. The use of ultrasound (US) during CVC has been recommended to improve patient safety. We performed a survey to evaluate the frequency of, and factors influencing, US use. ⋯ The use of US during CVC remains limited and is most strongly associated with the availability of equipment. Screening and rescue use of US are more common than real-time guidance. Our survey suggests that current use of US during CVC differs from existing evidence-based recommendations.
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Anesthesia and analgesia · Mar 2007
An analysis of transfusion practice and the role of intraoperative red blood cell salvage during cesarean delivery.
We sought to determine to what extent intraoperative salvaged red blood cells (RBC) might theoretically reduce exposure to appropriately transfused allogenic erythrocytes in Cesarean delivery patients. ⋯ Theoretically, based on best, average, and worst RBC salvage recovery calculations, 25.1%, 21.2%, or 14.5% of the appropriately transfused patients, respectively, could have completely avoided allogenic RBC transfusion.