Anesthesia and analgesia
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Anesthesia and analgesia · Apr 2012
Randomized Controlled TrialVocalization assessed by electrolaryngography is unaffected by topical lidocaine anesthesia: a prospective, crossover, randomized, double-blind placebo-controlled study.
Topical anesthesia of the upper airway is often recommended when difficulty in airway management is anticipated. There are published reports, however, of administration of topical anesthesia resulting in complete loss of airway control. Adverse effects are mostly attributed to interference with involuntary protective airway reflexes, while gross motor function itself generally is thought to be preserved. We hypothesized that if motor control is affected, measurable quantitative changes in vocalization should follow the use of topical anesthesia. ⋯ Although gargling with local anesthetic affected vocalization, no pharmacological effect attributable to local anesthetic was observed.
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Anesthesia and analgesia · Apr 2012
Multicenter StudyIncreases in electroencephalogram and electromyogram variability are associated with an increased incidence of intraoperative somatic response.
sBIS, the variability of the Bispectral Index (BIS), sEMG, the variability of facial electromyogram power (EMG), and the Composite Variability Index (CVI) are 3 new measures of electroencephalogram and EMG variability. CVI is a single measure of the combined variability in BIS and EMG. We investigated whether increases in these variables are associated with intraoperative somatic responses. ⋯ sBIS, sEMG, and CVI, measures of electroencephalogram and EMG variability, increased when intraoperative somatic events occurred. sBIS, sEMG, and CVI discriminated between 10-minute segments that contained a somatic event and those segments that did not contain an event better than changes in HR and mean arterial blood pressure. Furthermore, CVI increases before somatic events began earlier than HR changes and may provide caregivers with an early warning of potentially inadequate antinociception.