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
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.
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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
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.