Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial
A single dose of fentanyl and midazolam prior to Cesarean section have no adverse neonatal effects.
Analgesia and sedation, routinely used as adjunct medications for regional anesthesia, are rarely used in the pregnant patient because of concerns about adverse neonatal effects. In an effort to obtain more information about maternal analgesia and sedation we studied neonatal and maternal effects of iv fentanyl and midazolam prior to spinal anesthesia for elective Cesarean section. ⋯ Maternal analgesia and sedation with fentanyl (1 microg x kg(-1)) and midazolam (0.02 mg x kg(-1)) immediately prior to spinal anesthesia is not associated with adverse neonatal effects.
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Ideally, preoxygenation is performed using a tight fitting mask either by breathing normally for three to five minutes or with four to eight vital capacity (VC) breaths in 0.5 to one minute, but in practice leaks are frequent and sometimes unavoidable. This study was designed to determine which breathing method provided the best oxygenation in the presence of leak. ⋯ Preoxygenation with tidal volume breathing for three minutes yields higher F(EO(2)) in comparison to four VCs. If a small leak (4 mm internal diameter) is introduced, the F(EO(2)) decreases significantly with both breathing methods to approximately 60%.
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Randomized Controlled Trial
Bispectral index monitoring does not improve early recovery of geriatric outpatients undergoing brief surgical procedures.
To assess if titration of sevoflurane using the bispectral index (BIS) monitor improves the early and intermediate recovery in geriatric outpatients undergoing brief urologic procedures under general anesthesia without muscle relaxants. ⋯ In this non-paralyzed elderly outpatient surgery population, the use of BIS monitoring for titrating the maintenance anesthetic (sevoflurane) failed to improve the early recovery process.