Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial
Thoracic epidural analgesia improves pulmonary function in patients undergoing cardiac surgery.
Pulmonary dysfunction commonly occurs following coronary artery bypass graft (CABG) surgery, increasing morbidity and mortality. We hypothesized that thoracic epidural anesthesia (TEA) would improve pulmonary function and would decrease complications in patients undergoing CABG surgery. ⋯ High TEA decreases postoperative pain and atelectasis and improves pulmonary function in patients undergoing CABG surgery. Our results support the use of TEA in this group of patients.
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Randomized Controlled Trial Comparative Study
Comparison of two convective warming systems during major abdominal and orthopedic surgery.
Convective warming is routinely employed to maintain perioperative normothermia. However, due to differences in nozzle temperature and air flow of the power units, there are clinically relevant differences in heat transfer among convective warming systems. The purpose of this study was to evaluate the use of a quieter, convective warming system (WarmAir, sound pressure level 49 dba, air flow 35 cfm). The WarmAir system was compared to the standard, higher air flow system (Bair Hugger Model 750, sound pressure level 55 dba, air flow 48 cfm) with regards to temperature outcome. ⋯ Despite differences in heating characteristics, both convective warming systems were effective in maintaining perioperative normothermia in patients undergoing major abdominal and orthopedic surgery. Therefore, choice of warming system is dependent on other factors such as ergonomics and cost.
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Randomized Controlled Trial
Gabapentin does not reduce post-thoracotomy shoulder pain: a randomized, double-blind placebo-controlled study.
Despite adequate epidural analgesia, up to 97% of patients undergoing thoracotomy experience ipsilateral shoulder pain. In this setting, this study evaluated the safety and the efficacy of pre-emptive gabapentin. ⋯ Pre-emptively administered gabapentin, 1200 mg, does not reduce the incidence, or the severity, of post-thoracotomy shoulder pain in patients receiving thoracic epidural analgesia.
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Randomized Controlled Trial
Total intravenous anesthesia with propofol augments the potency of mivacurium.
Little is known about the potentiating effect of propofol on neuromuscular blocking drugs. However, some animal studies indicate a dose-dependent increase of the potency of neuromuscular blocking drugs by propofol. This study compared mivacurium potency after five minutes and after 20 min of total intravenous anesthesia with propofol (TIVA propofol). ⋯ After 20 min of TIVA propofol, the potency of mivacurium is approximately 50% greater than after five minutes of TIVA propofol. For clinical purposes, it is important, therefore, to consider the duration of TIVA propofol before determining the dose of neuromuscular blocking drug.