Anesthesia and analgesia
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Anesthesia and analgesia · Aug 2008
Controlled Clinical TrialA study of cognitive dysfunction in patients having carotid endarterectomy performed with regional anesthesia.
In previous studies, we found that approximately 25% of patients having carotid endarterectomy with general anesthesia (CEA general) develop cognitive dysfunction compared with a surgical control Group 1 day and 1 mo after surgery. In this study, we tested the hypothesis that patients having CEA with regional anesthesia (CEA regional) will develop significant cognitive dysfunction 1 day after surgery compared with a control group of patients receiving sedation 1 day after surgery. We did not study persistence of dysfunction. ⋯ Patients undergoing CEA regional had an incidence of cognitive dysfunction which was not different than patients having CEA general as previously published and compared with a contemporaneously enrolled group.
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Anesthesia and analgesia · Aug 2008
Comparative StudyThe intrathoracic blood volume index as an indicator of fluid responsiveness in critically ill patients with acute circulatory failure: a comparison with central venous pressure.
The intrathoracic blood volume index (ITBVI) and central venous pressure (CVP) are routinely used to predict fluid responsiveness in critically ill patients with acute circulatory failure (systolic blood pressure < 90 mm Hg or vasopressor requirement). However, they have never been compared. ⋯ ITBVI is similar to CVP in its ability to predict fluid responsiveness in critically ill patients with acute circulatory failure.
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Anesthesia and analgesia · Aug 2008
Case ReportsThe pivotal role of vasopressin in refractory anaphylactic shock.
Severe anaphylaxis can be associated with cardiovascular collapse that is difficult to manage and does not respond to treatment with epinephrine. Because anaphylaxis is uncommon, unpredictable and may be fatal, a prospective, randomized, controlled trial in humans on the best management is difficult and guidelines are based on theory and anecdotes only. ⋯ Standard treatment of anaphylactic shock, including discontinuation of the causative agent, administration of epinephrine, and infusion of IV fluids, did not stabilize cardiocirculatory function, and adding arginine vasopressors resulted in prompt hemodynamic stabilization.
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Anesthesia and analgesia · Aug 2008
Editorial Comment ReviewTreatment of anaphylactic shock: where is the evidence?
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Anesthesia and analgesia · Aug 2008
Case ReportsIntubation bougie dissection of tracheal mucosa and intratracheal airway obstruction.
Intubation bougies are commonly used to aid in intubation when an optimal view of the larynx is not obtained. We describe a case of tracheal perforation using a disposable intubation bougie resulting in a complete intratracheal airway obstruction relieved by cricothyrotomy. Disposable intubation bougies may have mechanical properties that differ from their nondisposable counterparts making complications more likely.