Anesthesia and analgesia
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Anesthesia and analgesia · Nov 2008
Randomized Controlled TrialIs albumin administration in hypoalbuminemic elderly cardiac surgery patients of benefit with regard to inflammation, endothelial activation, and long-term kidney function?
Because patients with low albumin levels may benefit from human albumin (HA) administration, we studied correction of hypovolemia with HA in hypoalbuminic elderly cardiac surgery patients. ⋯ Use of HA in hypoalbuminemic cardiac surgery patients aged >80 yr was without benefit with regard to inflammatory response, endothelial activation, and renal function compared to 6% HES 130/0.4.
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Anesthesia and analgesia · Nov 2008
Randomized Controlled TrialA randomized trial of dural puncture epidural technique compared with the standard epidural technique for labor analgesia.
We designed this prospective, double-blind, randomized study to examine whether a dural puncture without intrathecal drug administration immediately before epidural drug administration would improve labor analgesia when compared to a traditional epidural technique without prior dural puncture. ⋯ Dural puncture with a 25-G spinal needle immediately before the initiation of epidural analgesia improves the sacral spread, onset, and bilateral pain relief produced by analgesic concentrations of bupivacaine with fentanyl in laboring nulliparous patients.
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Anesthesia and analgesia · Nov 2008
Multicenter StudyTracheostomy in the intensive care unit: a nationwide survey.
The indication, timing and technique of tracheostomy have changed over the last several years. We performed a survey to assess the current practice of tracheostomy in German intensive care units (ICUs). ⋯ Percutaneous dilatational tracheostomy is the procedure of choice for tracheostomy in critically ill patients in Germany. The modified Ciaglia technique is the preferred percutaneous technique, and nearly all physicians routinely use bronchoscopic guidance. Most tracheostomies are done during the second week of mechanical ventilation.
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Anesthesia and analgesia · Nov 2008
Randomized Controlled TrialA vein entry indicator device for facilitating peripheral intravenous cannulation in children: a prospective, randomized, controlled trial.
Vascular access is often technically difficult in children because of the small caliber and impalpability of the veins. In this study, we sought to determine if use of the Vein Entry Indicator Device (VEIDtrade mark) in children facilitates peripheral venous access. ⋯ The VEID facilitates the insertion of peripheral venous cannulas in healthy children with intermediate/difficult veins undergoing same-day surgery, reducing the number of attempts and the overall time required.
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Anesthesia and analgesia · Nov 2008
The dynamic relationship between end-tidal sevoflurane concentrations, bispectral index, and cerebral state index in children.
To guide anesthetic administration with electroencephalogram monitors in children, an adequate characterization of the anesthetic effect measured by these monitors in this population is needed. We sought to quantify and compare the dynamic profile of sevoflurane's effect measured with the cerebral state index (CSI) and the bispectral index (BIS) in children. ⋯ In children, the t(1/2) k(e0) of sevoflurane and the pharmacodynamics of sevoflurane were quantified and the results were entirely dependent on the monitor used to measure its hypnotic effect. Within the anesthetic depth range studied, the rate of change of sevoflurane's effect was slower with the CSI. To adequately guide sevoflurane administration with these monitors in children, these differences should be considered.