Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2013
Randomized Controlled TrialContinuous interscalene block in patients having outpatient rotator cuff repair surgery: a prospective randomized trial.
Continuous interscalene block offers analgesic benefits up to 1 week after shoulder surgery when compared with either single-shot block or GA alone.
pearl -
Anesthesia and analgesia · Dec 2013
Randomized Controlled Trial Comparative StudyAnesthesia induction using video glasses as a distraction tool for the management of preoperative anxiety in children.
Distraction technology suitable for the perioperative setting is readily available, but there is little evidence to show how it compares with oral midazolam in managing anxiety. Video glasses, which enable children to view and listen to cartoons and movies, may be used through the completion of inhaled induction. We compared the efficacy of oral midazolam and behavioral distraction with video glasses in managing preoperative anxiety in children. ⋯ The use of video glasses and midazolam alone or in combination maintains baseline levels of anxiety at time of transport to the OR and prevents significantly increased anxiety during induction of anesthesia in children. Video glasses are not inferior to midazolam for preoperative anxiolysis and provide a safe, noninvasive, nonpharmacologic, and pleasant alternative.
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Anesthesia and analgesia · Dec 2013
Randomized Controlled Trial Comparative StudyThe effectiveness of pudendal nerve block versus caudal block anesthesia for hypospadias in children.
Pudendal nerve block provides better analgesia in the first 24 hours for children following hypospadias repair than does caudal block.
pearl -
Anesthesia and analgesia · Dec 2013
Randomized Controlled Trial Comparative StudyUnder general anesthesia arginine vasopressin prevents hypotension but impairs cerebral oxygenation during arthroscopic shoulder surgery in the beach chair position.
Patients undergoing surgery in the beach chair position (BCP) are at a risk of cerebral ischemia. We evaluated the effect of arginine vasopressin (AVP) on hemodynamics and cerebral oxygenation during surgery in the BCP. ⋯ A prophylactic bolus administration of AVP prevents hypotension associated with BCP in patients undergoing shoulder surgery under general anesthesia. However, it was associated with regional cerebral but not jugular venous oxygen desaturation on upright positioning.
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Anesthesia and analgesia · Dec 2013
Randomized Controlled TrialThe effect of cisatracurium and rocuronium on lung function in anesthetized children.
Neuromuscular blocking drugs have been implicated in intraoperative bronchoconstrictive episodes. We examined the effects of clinically relevant doses of cisatracurium and rocuronium on the lung mechanics of pediatric subjects. We hypothesized that cisatracurium and rocuronium would have bronchoconstrictive effects. ⋯ At clinically relevant doses, both cisatracurium and rocuronium caused changes in lung function, indicating constriction of smaller airways. In general, these changes were mild and not clinically detectable. However, in the rocuronium group, 3 of 13 patients showed more noticeable decreases in MEF10 (≤50%), demonstrating the potential for significant broncho-bronchiolar constriction in susceptible patients.