Anesthesia and analgesia
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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 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.
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Anesthesia and analgesia · Mar 2008
Comparative StudyCardiac output derived from arterial pressure waveform analysis in patients undergoing cardiac surgery: validity of a second generation device.
The performance of a recently introduced, arterial waveform-based device for measuring cardiac output (CO) without the need of invasive calibration (FloTrac/Vigileo) has been controversial. We designed the present study to assess the validity of an improved version of this monitoring technique compared with intermittent thermodilution CO measurement using a pulmonary artery catheter in patients undergoing cardiac surgery. ⋯ CI values obtained by the improved, second generation semiinvasive arterial waveform device showed good intraoperative and postoperative agreement with intermittent pulmonary artery thermodilution CI measurements in patients undergoing coronary artery bypass graft surgery.
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Anesthesia and analgesia · Mar 2008
Multicenter Study Comparative Study Clinical TrialA simplified approach to vertical infraclavicular brachial plexus blockade using hand-held Doppler.
In this observational study, we used Doppler ultrasound during the performance of vertical infraclavicular brachial plexus blockade. The success rate at inserting the needle at the point where the sound of the subclavian artery via Doppler reached its maximum audibility was compared with that of the classical insertion point. In 89 of the 100 patients, the medial or posterior cord was found at first needle pass. Using the Doppler point for insertion resulted in a significantly more lateral entry point compared with the classical point (P < 0.001) and was associated with a high success rate of infraclavicular block.
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Anesthesia and analgesia · Mar 2008
Randomized Controlled TrialA prospective randomized double-blind study to determine the effect of thoracic epidural neostigmine on postoperative ileus after abdominal aortic surgery.
Postoperative ileus is a major gastrointestinal complication of abdominal aortic surgery leading to increased rates of morbidity and mortality, longer lengths of hospital stay, and higher costs. In this study, we evaluated the effect of epidurally administered neostigmine on postoperative ileus after abdominal aortic surgery. ⋯ Thoracic epidural neostigmine enables faster restoration of bowel sounds and shortens duration of postoperative ileus after abdominal aortic surgery.