Anesthesia and analgesia
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Anesthesia and analgesia · Feb 2009
Randomized Controlled TrialThe analgesic effect of epidural clonidine after spinal surgery: a randomized placebo-controlled trial.
Clonidine is an alpha(2) adrenoreceptor and imidazoline receptor agonist, which has analgesic, sedative, and minimum alveolar anesthetic concentration-sparing effects. It has been used orally, IV, and epidurally. In spinal surgery, there is a reluctance to use local anesthetic-based epidural analgesia postoperatively because of fears of masking important signs of nerve root or spinal cord injury. ⋯ Low-dose epidural clonidine significantly reduced the demand for morphine and reduced postoperative nausea with few side effects.
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Anesthesia and analgesia · Feb 2009
Randomized Controlled Trial Comparative StudyThe efficacy of perfusion index as an indicator for intravascular injection of epinephrine-containing epidural test dose in propofol-anesthetized adults.
Perfusion index (PI) is a noninvasive numerical value of peripheral perfusion obtained from a pulse oximeter. In this study, we evaluated the efficacy of PI for detecting intravascular injection of a simulated epidural test dose containing 15 mug of epinephrine in adults during propofol-based anesthesia and compared its reliability with the conventional heart rate (HR) (positive if >or=10 bpm) and systolic blood pressure (SBP) (positive if >or=15 mm Hg) criteria. ⋯ PI is a reliable alternative to conventional hemodynamic criteria for detection of an intravascular injection of epidural test dose in propofol-anesthetized adult patients.
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Anesthesia and analgesia · Feb 2009
Multicenter Study Clinical TrialC50 for propofol-remifentanil target-controlled infusion and bispectral index at loss of consciousness and response to painful stimulus in Chinese patients: a multicenter clinical trial.
In this study, we evaluated the predicted blood and effect-site C(50) for propofol and remifentanil target-controlled infusion and the Bispectral Index (BIS) values at loss of consciousness (LOC) and response to a standard noxious painful stimulus in Chinese patients. We hypothesized that these values would be different from previously published data on Caucasians. ⋯ The predicted blood and effect-site concentrations of propofol and BIS values at LOC were lower than those in previously published studies of Caucasian populations.
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Anesthesia and analgesia · Feb 2009
Randomized Controlled TrialThe effect of Trendelenburg position, lactated Ringer's solution and 6% hydroxyethyl starch solution on cardiac output after spinal anesthesia.
The aim of our study was to evaluate the effects of Trendelenburg position, infusion of 6% hydroxyetyl starch solution or lactated Ringer's solution on changes in cardiac output (CO) after spinal anesthesia in patients older than 50 yr. ⋯ Our study demonstrated that a decrease in CO after spinal anesthesia is prevented by placing the patient in the Trendelenburg position, or infusion of either lactated Ringer's solution or 6% hydroxyetyl starch solution. Although the effects of the infusion of the lactated Ringer's solution are transient, the effects of the infusion of 6% hydroxyethyl starch solution are extended beyond the time the infusion.
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Anesthesia and analgesia · Feb 2009
Case scheduling preferences of one Surgeon's cataract surgery patients.
The increase in the number of operating rooms nationwide in the United States may reflect preferences of patients for scheduling of outpatient surgery. Yet, little is known of the importance that patients place on scheduling convenience and flexibility. ⋯ The patients of this ophthalmologist placed a high value on convenience and flexibility in scheduling their surgery. In general, this would be achievable only if many operating rooms were available each morning.