Anesthesia and analgesia
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Anesthesia and analgesia · Feb 2009
Randomized Controlled TrialWeaning automation with adaptive support ventilation: a randomized controlled trial in cardiothoracic surgery patients.
Adaptive support ventilation (ASV) is a microprocessor-controlled mode of mechanical ventilation that switches automatically from controlled ventilation to assisted ventilation and selects ventilatory settings according to measured lung mechanics. ⋯ Weaning automation with ASV is feasible and safe in non-fast-track coronary artery bypass grafting patients. Time until tracheal extubation with ASV equals time until tracheal extubation with standard weaning and allows for frequent (automatic) switches between controlled and assisted ventilation.
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Anesthesia and analgesia · Feb 2009
The effects of xenon anesthesia on the relationship between cerebral glucose metabolism and blood flow in healthy subjects: a positron emission tomography study.
General anesthetics can alter the relationship between regional cerebral glucose metabolism (rCMR(glc)) and blood flow (rCBF). In this positron emission tomography study, our aim was to assess both rCMR(glc) and rCBF in the same individuals during xenon anesthesia. ⋯ In general, the magnitude of the decreases in rCMR(glc) during 1 minimum alveolar anesthetic concentration xenon anesthesia exceeded the reductions in rCBF. As a result, the ratio between rCMR(glc) and rCBF was shifted to a higher level. Interestingly, xenon-induced changes in cerebral metabolism and blood flow resemble those induced by volatile anesthetics.
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Anesthesia and analgesia · Feb 2009
Review Meta AnalysisAwareness during anesthesia: risk factors, causes and sequelae: a review of reported cases in the literature.
Awareness during anesthesia is uncommon. The number of cases that are found in one single study are insufficient to identify and estimate the risks, causal factors and sequelae. One method of studying a large number of cases is to analyze reports of cases of awareness that have been published in scientific journals. ⋯ Our review suggested light anesthesia and a history of awareness as risk factors. Obesity and avoidance of nitrous oxide use did not seem to increase the risk. Light anesthesia was the most common cause. Our findings suggest preventive procedures that may lead to a decrease in the incidence of awareness.
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Anesthesia and analgesia · Feb 2009
Randomized Controlled Trial Comparative StudySpray-as-you-go airway topical anesthesia in patients with a difficult airway: a randomized, double-blind comparison of 2% and 4% lidocaine.
We designed this randomized, double-blind clinical study to compare the safety and efficacy of 2% and 4% lidocaine during airway topical anesthesia with a spray-as-you-go technique via the fiberoptic bronchoscope. ⋯ Both 2% and 4% lidocaine administered topically by a spray-as-you-go technique can provide clinically acceptable intubating conditions for awake FOI in sedated patients with a difficult airway. As compared with 4% lidocaine, however, 2% lidocaine requires a smaller dosage and results in lower plasma concentrations.