Anesthesia and analgesia
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Anesthesia and analgesia · Mar 2008
Randomized Controlled Trial Comparative StudyA prospective comparison of continuous wound infiltration with ropivacaine versus single-injection paravertebral block after modified radical mastectomy.
The efficacy of continuous wound infiltration with local anesthetic has not been compared with that of thoracic paravertebral block (PVB) after breast surgery. In this study, we evaluated the analgesic efficacy and morphine consumption of the two techniques after mastectomy. ⋯ Continuous wound infiltration of local anesthetics is an effective alternative to paravertebral analgesia after mastectomy with axillary dissection.
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Anesthesia and analgesia · Mar 2008
Randomized Controlled TrialAn evaluation of a full-access underbody forced-air warming system during near-normothermic, on-pump cardiac surgery.
A new underbody forced-air warming system is available for use during cardiac surgery. We tested the hypothesis combining underbody forced-air warming with standard thermal management would maintain intraoperative core temperature and reduce core temperature after-drop (largest decrease in core temperature in the 60 min after bypass) in patients undergoing near-normothermic cardiopulmonary bypass (CPB). ⋯ Adding an underbody forced-air warming system to the near-normothermic thermal management protocol significantly increased pre-bypass temperature; however, it had no further clinically important effect on core temperature.
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Anesthesia and analgesia · Mar 2008
Randomized Controlled Trial Comparative StudyThe effective concentration 50 (EC50) for propofol with 70% xenon versus 70% nitrous oxide.
Xenon anesthesia has many favorable properties, such as pain modulation and organ protection. However, due to its MAC of 70%, it cannot be used as a sole anesthetic. We estimated the amount of propofol required to supplement xenon to produce adequate anesthesia in 50% and 95% of patients in comparison with nitrous oxide. ⋯ Xenon seems to be clinically more potent than nitrous oxide, but still requires minimal supplement of a hypnotic anesthetic to suppress noxious stimulation during and after skin incision.
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Anesthesia and analgesia · Mar 2008
Comment ReviewPreoperative coronary revascularization in high-risk patients undergoing vascular surgery: a core review.
Patients undergoing vascular surgery are at increased risk for cardiac complications related to the presence of underlying coronary artery disease. Preoperative cardiac evaluation may help to identify high-risk patients in whom coronary angiography may be planned with subsequent coronary revascularization for the purpose of improving perioperative and long-term cardiac outcomes. However, the indications and efficacy for type of revascularization for the reduction of cardiac complications compared to medical therapy has been controversial. My aim in this review is to summarize the role of preoperative revascularization compared to conservative medical therapy before elective vascular surgery using current evidence from published studies.
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Anesthesia and analgesia · Mar 2008
Randomized Controlled Trial Comparative StudyCervical spine motion during tracheal intubation with manual in-line stabilization: direct laryngoscopy versus GlideScope videolaryngoscopy.
The optimal tracheal intubation technique for patients with potential cervical (C) spine injury remains controversial. Using continuous cinefluoroscopy, we conducted a prospective study comparing C-spine movement during intubation using direct laryngoscopy (DL) or GlideScope videolaryngoscopy (GVL), with uninterrupted manual in-line stabilization of the head by an assistant. ⋯ During intubation under general anesthesia with neuromuscular blockade and manual in-line stabilization, the use of GVL produced better glottic visualization, but did not significantly decrease movement of the nonpathologic C-spine when compared with DL.