Anesthesia and analgesia
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Anesthesia and analgesia · May 2011
Randomized Controlled TrialHigh-dose remifentanil suppresses sinoatrial conduction and sinus node automaticity in pediatric patients under propofol-based anesthesia.
We sought to determine the effect of remifentanil on sinus node function and the atrial-His (AH) interval in pediatric patients undergoing radiofrequency catheter ablation. ⋯ Remifentanil may inhibit both intraatrial conduction and sinus node automaticity, but it has no effect on conduction through the atrioventricular node. Dose dependency was not observed within the range of 0.2 to 0.4 μg · kg(-1) · min(-1) of remifentanil.
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Anesthesia and analgesia · May 2011
Randomized Controlled Trial Comparative StudyDreaming in sedation during spinal anesthesia: a comparison of propofol and midazolam infusion.
Although sedation is often performed during spinal anesthesia, the details of intraoperative dreaming have not been reported. We designed this prospective study to compare 2 different IV sedation protocols (propofol and midazolam infusion) with respect to dreaming during sedation. ⋯ In cases of spinal anesthesia with deep sedation, dreaming was almost 5 times more common in patients receiving propofol infusion than in those receiving midazolam, although this did not influence satisfaction with the sedation. Thus, one does not need to consider intraoperative dreaming when choosing propofol or midazolam as a sedative drug in patients undergoing spinal anesthesia.
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Anesthesia and analgesia · May 2011
Randomized Controlled TrialBrief report: the effect of suggestion on unpleasant dreams induced by ketamine administration.
The use of ketamine may be associated with the recall of unpleasant dreams after sedation. We hypothesized that a positive suggestion before sedation could reduce the incidence of ketamine-induced unpleasant dreams. To test this hypothesis, we randomized 100 patients receiving sedation with ketamine for their procedure into 2 groups with 1 group having an anesthesiologist provide a mood-elevating suggestion to the patient before ketamine administration (suggestion group), whereas in the control group no suggestion was provided. ⋯ In those patients who lost consciousness, the frequencies of grades 1, 2, 3, 4, and 5 were 0%, 0%, 46%, 24%, and 30% in the suggestion group and were 6%, 2%, 70%, 12%, and 10%, respectively, in the control group (P=0.01). In the intent-to-treat population the overall frequency between groups was very similar. This study implies that when administering ketamine as part of a sedation regimen, positive suggestion may help reduce the recall of unpleasant dreaming.
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Anesthesia and analgesia · May 2011
Randomized Controlled Trial Comparative StudyIdentification of the correct cervical level by palpation of spinous processes.
The ability to identify the correct vertebral level through examination is an important skill for clinicians who are performing nerve blocks without fluoroscopy. The conventional palpation method, which identifies the most prominent cervical spinous process as the seventh cervical (C7) spinous process is unreliable in many cases. We compared the accuracy of 2 different palpation methods used for identifying C7. ⋯ The flexion-extension method is more accurate than the conventional method when identifying cervical vertebral level.