Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Best evidence in anesthetic practice: prevention: epidural anesthesia and analgesia does not reduce 30-day all-cause mortality and major morbidity after abdominal surgery.
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Randomized Controlled Trial Comparative Study Clinical Trial
Muscle relaxation and increasing doses of propofol improve intubating conditions.
Muscle relaxants and anesthetics are usually associated during intubation. However, their relative role to facilitate the process is not clearly defined. This study was designed to determine, during intubation: i). the relative role of anesthetics and atracurium-induced neuromuscular block and; ii). the effect of different doses of propofol in the presence of complete muscle block. ⋯ Our study confirms the interaction between anesthesia and muscle relaxation to produce adequate intubating conditions. In the conditions described, intubating conditions were more dependent on atracurium-induced neuromuscular blockade than on anesthetics, but both atracurium and propofol improved intubating conditions.
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Randomized Controlled Trial Clinical Trial
Magnesium potentiates neuromuscular blockade with cisatracurium during cardiac surgery.
Magnesium potentiates the effect of nondepolarizing neuromuscular blocking agents. It is used in cardiac anesthesia to prevent hypertension and arrhythmias. This study was performed to measure the interaction between magnesium and cisatracurium in cardiac surgery. ⋯ In patients undergoing cardiac surgery, administration of magnesium sulfate, resulting in ionized levels of 1.3 mmol x L(-1), results in a 30-35 min prolongation of the neuromuscular blockade induced with intubating and maintenance doses of cisatracurium and does not alter hemodynamic stability.
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Randomized Controlled Trial Clinical Trial
Propofol - not thiopental or etomidate - with remifentanil provides adequate intubating conditions in the absence of neuromuscular blockade.
Administration of remifentanil followed by propofol provides adequate conditions for tracheal intubation without muscle relaxants. Other hypnotic drugs have not been thoroughly investigated in this regard. Intubating conditions with remifentanil followed by propofol, thiopentone or etomidate are compared in this study. ⋯ Propofol 2 mg x kg(-1) was superior to thiopentone 6 mg x kg(-1) and etomidate 0.3 mg x kg(-1) for tracheal intubation when combined with remifentanil 3 microg x kg(-1) and no muscle relaxant.
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Randomized Controlled Trial Clinical Trial
A combination of alfentanil-lidocaine-propofol provides better intubating conditions than fentanyl-lidocaine-propofol in the absence of muscle relaxants.
To compare the ease of tracheal intubation without the use of muscle relaxants following an alfentanil-lidocaine-propofol sequence vs a fentanyl-lidocaine-propofol sequence. ⋯ An alfentanil-lidocaine-propofol sequence offers significantly better intubating conditions than a fentanyl-lidocaine-propofol sequence in healthy adult patients.