Anesthesia and analgesia
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Anesthesia and analgesia · Aug 2007
Randomized Controlled Trial Comparative StudyClonidine 1 microg/kg is a safe and effective adjuvant to plain bupivacaine in spinal anesthesia in adolescents.
Spinal anesthesia is increasingly used in adolescents. However, the anesthesia provided by bupivacaine alone may be too short for the planned surgery. The addition of clonidine 2 microg/kg to bupivacaine provides a prolonged anesthetic action but may be associated with hypotension. In the present study, we investigated the efficacy and safety of intrathecal clonidine 1 mug/kg in adjunction to bupivacaine in spinal anesthesia in adolescents. ⋯ In adolescents, clonidine 1 microg/kg prolonged the duration of sensory block achieved with bupivacaine by 30 min and postoperative analgesia by 120 min without severe adverse events.
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Anesthesia and analgesia · Aug 2007
Randomized Controlled Trial Comparative StudyEutectic mixture of local anesthetic (EMLA) decreases pain during humeral block placement in nonsedated patients.
We evaluated the potential role of an euctectic mixture of local anesthetic (EMLA) cream application before performing midhumeral block. ⋯ The patients who received EMLA cream had less pain with needle puncture as well as throughout the performance of humeral block.
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Anesthesia and analgesia · Aug 2007
Randomized Controlled Trial Comparative StudyA comparison of three different concentrations of ropivacaine with fentanyl for patient-controlled epidural analgesia.
The optimal concentration of ropivacaine in combination with fentanyl for patient-controlled epidural analgesia focusing on preservation of bowel function, analgesia, and motor function remains unclear. ⋯ We conclude that ropivacaine 0.05% is sufficient to preserve gastrointestinal motility, and provides excellent postoperative pain relief without motor blockade.
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Anesthesia and analgesia · Aug 2007
Comparative StudyAnesthesia-related cardiac arrest in children: update from the Pediatric Perioperative Cardiac Arrest Registry.
The initial findings from the Pediatric Perioperative Cardiac Arrest (POCA) Registry (1994-1997) revealed that medication-related causes, often cardiovascular depression from halothane, were the most common. Changes in pediatric anesthesia practice may have altered the causes of cardiac arrest in anesthetized children. ⋯ A reduction in the proportion of arrests related to cardiovascular depression due to halothane may be related to the declining use of halothane in pediatric anesthetic practice. The incidence of the most common remaining causes of arrest in each category may be reduced through preventive measures.
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Anesthesia and analgesia · Aug 2007
Comparative StudyTrendelenburg position, simulated Valsalva maneuver, and liver compression do not alter the size of the right internal jugular vein in patients with a bidirectional Glenn shunt.
Ultrasound is increasingly used to facilitate right internal jugular vein (RIJV) cannulation in children. In children without cardiac disease, position changes and enhancement maneuvers increase RIJV cross-sectional area (CSA) and further facilitate cannulation. We investigated the effect of these maneuvers on RIJV CSA in children with a bidirectional Glenn (BDG) shunt presenting for a Fontan procedure. ⋯ Position changes and enhancement maneuvers are unlikely to facilitate RIJV cannulation in BDG shunt patients presenting for Fontan procedure because these interventions do not increase RIJV CSA.