European journal of anaesthesiology
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As atelectasis occurs in most patients during general anaesthesia and may be one of the major causes for the development of hypoxaemia and nosocomial pneumonia, its prevention may be considered as an important objective in perioperative management. The major causative mechanisms are the loss of respiratory muscle tone, compression and gas absorption. ⋯ In this review we describe the pathogenesis of atelectasis in the perioperative period and discuss in the light of recent published investigations the suitability of the vital capacity manoeuvre as a tool during general anaesthesia. Reviewing the current literature, a vital capacity manoeuvre during general anaesthesia may only be useful under specific circumstances when mechanical ventilation with a high inspiratory fraction of oxygen is required or during cardiac surgery at the end of cardiopulmonary bypass to reduce the amount of atelectasis and to maintain adequate gas exchange.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of patient-controlled and operator-controlled conscious sedation for restorative dentistry.
The use of midazolam for conscious sedation is an accepted method of anxiety control in restorative dentistry. A lack of predictability in its effects requires the dose of midazolam to be adjusted to individual patient's requirements. We determined whether patient-controlled sedation was a suitable alternative to operator-controlled sedation in restorative dentistry. ⋯ This study shows that patient-controlled sedation is a suitable alternative to operator-controlled sedation in the management of anxious dental patients.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Conventional stepwise vs. vital capacity rapid inhalation induction at two concentrations of sevoflurane.
A multicentre study was conducted to compare three methods of inhalation induction with sevoflurane in adult premedicated patients. ⋯ Inhalation induction of anaesthesia with sevoflurane with the three techniques tested is safe, reliable and well accepted by the patients. The vital capacity rapid inhalation group primed with sevoflurane 8% was the fastest method with no relevant side-effects.
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Comparative Study
Ethnic differences in propofol and fentanyl response: a comparison among Caucasians, Kenyan Africans and Brazilians.
Differences in sensitivity to anaesthetic drugs may exist among human races. Allelic variants for drug metabolizing isoenzymes and other pharmacokinetic/pharmacodynamic differences may account for a variable response to anaesthetic drugs. This study was designed to investigate comparatively the anaesthetic requirements and the recovery trends of three different ethnic groups: Caucasians, African blacks and Brazilians. ⋯ The recovery of Kenyan African blacks from anaesthesia with propofol and fentanyl is much slower, in comparison with Caucasians. The recovery time of Brazilians is much more variable, in comparison with Caucasians.
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Comparative Study
Changes in respiratory physiological dead space and compliance during non-abdominal, upper abdominal and lower abdominal surgery under general anaesthesia.
To evaluate the temporal changes in respiratory physiological dead space and dynamic compliance of the respiratory system during non-abdominal, upper abdominal and lower abdominal surgery under general anaesthesia with intermittent positive pressure ventilation. ⋯ We found that the VD/VT increased in patients undergoing lower abdominal surgery in lithotomy and head down tilt, and compliance decreased in those undergoing upper abdominal and lower abdominal surgery over time.