Anesthesia and analgesia
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Anesthesia and analgesia · Oct 2012
ReviewClinical uses of the Bonfils Retromolar Intubation Fiberscope: a review.
The Bonfils Retromolar Intubation Fiberscope is a rigid, straight fiberoptic device with a 40-degree curved tip, which facilitates targeted intubation. Bonfils, using a retromolar approach to intubate tracheas of children with Pierre Robin syndrome, was first described in 1983. After an initial steep learning curve, the Bonfils becomes a useful device in the management of normal and difficult airways. ⋯ Although the intubation success rate is high, it is still very much operator dependent. Time to intubation is inferior to conventional laryngoscopy, and its expense may be an issue in some centers. In conclusion, the Bonfils is an effective tool for management of the difficult airway after initial training.
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Anesthesia and analgesia · Oct 2012
Randomized Controlled TrialIncreased long-term mortality after a high perioperative inspiratory oxygen fraction during abdominal surgery: follow-up of a randomized clinical trial.
A high perioperative inspiratory oxygen fraction (80%) has been recommended to prevent postoperative wound infections. However, the most recent and one of the largest trials, the PROXI trial, found no reduction in surgical site infection, and 30-day mortality was higher in patients given 80% oxygen. In this follow-up study of the PROXI trial we assessed the association between long-term mortality and perioperative oxygen fraction in patients undergoing abdominal surgery. ⋯ Administration of 80% oxygen in the perioperative period was associated with significantly increased long-term mortality and this appeared to be statistically significant in patients undergoing cancer surgery but not in noncancer patients.
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Anesthesia and analgesia · Oct 2012
ReviewComplement activation and cardiac surgery: a novel target for improving outcomes.
Complement activation and the resulting inflammatory response is an important potential mechanism for multisystem organ injury in cardiac surgery. Novel therapeutic strategies using complement inhibitors may hold promise for improving outcomes for cardiac surgical patients by attenuating complement activation or its biologically active effector molecules. Recent clinical trials evaluating complement inhibitors have provided important data to further delineate the impact of complement activation and its inhibition on clinical outcomes. In this review we examine the role of complement activation and its inhibition as a therapeutic approach in cardiac surgery.
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Anesthesia and analgesia · Oct 2012
ReviewEn face view of the mitral valve: definition and acquisition.
A 3-dimensional echocardiographic view of the mitral valve, called the "en face" or "surgical view," presents a view of the mitral valve similar to that seen by the surgeon from a left atrial perspective. Although the anatomical landmarks of this view are well defined, no comprehensive echocardiographic definition has been presented. After reviewing the literature, we provide a definition of the left atrial and left ventricular en face views of the mitral valve. Techniques used to acquire this view are also discussed.
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Anesthesia and analgesia · Oct 2012
Randomized Controlled TrialTransversus abdominis plane block for analgesia in renal transplantation: a randomized controlled trial.
The transversus abdominis plane (TAP) block has proven effective in reducing opioid requirements and pain scores for some procedures involving the lower abdominal wall. In this study we assessed its efficacy in patients with end-stage renal failure undergoing cadaveric renal transplantation. ⋯ The addition of a TAP block to the analgesia regimen for renal transplantation did not reduce morphine requirements.