Anesthesia and analgesia
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Anesthesia and analgesia · Jul 2007
Randomized Controlled Trial Comparative StudyRemifentanil halves the EC50 of propofol for successful insertion of the laryngeal mask airway and laryngeal tube in pediatric patients.
Propofol and remifentanil are the drugs of choice for insertion of the supraglottic airway without muscle relaxants for short duration surgery. In this study, we compared propofol concentrations required for insertion of laryngeal mask way (LMA) or laryngeal tube (LT) with and without remifentanil. ⋯ Remifentanil 7.5 ng/mL reduced the propofol concentration required for airway insertion by half, and improved conditions for insertion. Propofol concentrations for insertion of the LMA and LT were similar.
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Anesthesia and analgesia · Jul 2007
ReviewA systematic review of postoperative recovery outcomes measurements after ambulatory surgery.
Mortality and morbidity in ambulatory surgery are rare, and thus the patient's quality of life (i.e., the ability to resume normal activities after discharge home) should be considered one of the principle end-points after ambulatory surgery and anesthesia. We conducted a systematic review of the instruments to measure the quality of recovery of ambulatory surgical patients in order to advise on the selection of appropriate measures for research and quality assurance. ⋯ Only one instrument, 40-item Quality of recovery score, fulfilled all eight criteria, however this instrument was not specifically designed for ambulatory surgery and anesthesia.
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Anesthesia and analgesia · Jul 2007
Comparative StudyContinuous monitoring of dynamic pulmonary compliance enables detection of endobronchial intubation in infants and children.
Auscultation of breath sounds is used routinely to confirm tracheal placement of endotracheal tubes (ETT). In infants and children, this method is limited by the conduction of breath sounds bilaterally, despite endobronchial intubation. Although several methods of detecting endobronchial intubation have been described, none is both simple and reliable. In this investigation, we determined whether changes in pulmonary compliance and airway pressures, measured using continuous side stream spirometry, can reliably detect endobronchial intubation in pediatric patients. ⋯ Pulmonary compliance changes are a sensitive and an accurate indicator of endobronchial intubation in infants and children. Both increased peak airway pressures and changes in breath sounds are less sensitive indicators of endobronchial intubation.
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Anesthesia and analgesia · Jul 2007
Comparative StudyAnesthetic properties of carbon dioxide in the rat.
Carbon dioxide decreases halothane minimum alveolar concentrations (MAC) in dogs when Paco(2) exceeds 95 mm Hg. We sought to confirm these findings for several potent inhaled anesthetics in rats. ⋯ Unlike dogs, no threshold for the CO(2)-MAC response arose with halothane, isoflurane, or desflurane in rats. The ED(50) for CO(2) is also approximately 50% greater in rats than reported in dogs.