Anesthesia and analgesia
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Anesthesia and analgesia · Apr 2009
Randomized Controlled Trial Comparative StudyChoosing a lung isolation device for thoracic surgery: a randomized trial of three bronchial blockers versus double-lumen tubes.
There is no consensus on the best technique for lung isolation for thoracic surgery. In this study, we compared the clinical performance of three bronchial blockers (BBs) available in North America with left-sided double-lumen tubes (DLTs) for lung isolation in patients undergoing left-sided thoracic surgery. ⋯ The three BBs provided equivalent surgical exposure to left-sided DLTs during left-sided open or video-assisted thoracoscopic surgery thoracic procedures. BBs required longer to position and required intraoperative repositioning more often. The Arndt BB needed to be repositioned more often than the other BBs.
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Anesthesia and analgesia · Apr 2009
Randomized Controlled TrialThe effect of pregabalin on preoperative anxiety and sedation levels: a dose-ranging study.
Pregabalin is a gabapentinoid compound, which has been alleged to possess anxiolytic, analgesic, and anticonvulsant properties. We hypothesized that premedication with oral pregabalin would produce dose-related reductions in acute (state) anxiety and increases in sedation (sleepiness) before induction of general anesthesia. A secondary objective was to determine if premedication with pregabalin would reduce postoperative pain. ⋯ Preoperative pregabalin administration (75-300 mg po) increased perioperative sedation in a dose-related fashion, but failed to reduce preoperative state anxiety, postoperative pain, or to improve the recovery process after minor elective surgery procedures.
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Anesthesia and analgesia · Apr 2009
Randomized Controlled Trial Comparative StudyThe use of air in the inspired gas mixture during two-lung ventilation delays lung collapse during one-lung ventilation.
Collapse of the ipsilateral lung facilitates surgical exposure during thoracic procedures. The use of different gas mixtures during two-lung ventilation (2LV) may improve or impede surgical conditions during subsequent one-lung ventilation (OLV) by increasing or delaying lung collapse. We investigated the effects of three different gas mixtures during 2LV on lung collapse and oxygenation during subsequent OLV: Air/Oxygen (fraction of inspired oxygen [FIO(2)] = 0.4), Nitrous Oxide/Oxygen ("N(2)O," FIO(2) = 0.4) and Oxygen ("O(2)," FIO(2) = 1.0). ⋯ De-nitrogenation of the lung during 2LV is a useful strategy to improve surgical conditions during OLV. The use of FIO(2) 1.0 or N(2)O/O(2) (FIO(2) 0.4) during 2LV did not have an adverse effect on subsequent oxygenation during OLV.
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Anesthesia and analgesia · Apr 2009
Randomized Controlled Trial Comparative StudyA comparison of lighted stylet (Surch-Lite) and direct laryngoscopic intubation in patients with high Mallampati scores.
A lighted stylet is an effective alternative to a direct laryngoscope and has been reported to be particularly useful in patients with difficult airways. A high Mallampati class indicates poor visibility of the oropharyngeal structures. Because a lighted stylet does not require direct oropharyngeal visualization, we hypothesized that the lighted stylet would be easier to use than a direct laryngoscope in patients with a high Mallampati score. To examine our hypothesis, we performed a prospective, randomized study comparing a lighted stylet (Surch-Lite) with direct laryngoscopy in patients with high Mallampati scores. Success rate, time required for intubation, and hemodynamic changes were compared. ⋯ The Surch-Lite showed a higher success rate on the first intubation attempt and produced an attenuated hemodynamic response to endotracheal intubation of patients with high Mallampati score. Thus, the Surch-Lite is an effective alternative to direct laryngoscopy in these patients.
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Anesthesia and analgesia · Apr 2009
Randomized Controlled TrialThe effect of melatonin on sleep quality after laparoscopic cholecystectomy: a randomized, placebo-controlled trial.
In this study, we investigated whether melatonin administration could improve postoperative subjective sleep quality and reduce discomfort. ⋯ Melatonin did not improve subjective sleep quality or discomfort compared with placebo after laparoscopic cholecystectomy.