Journal of clinical anesthesia
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Randomized Controlled Trial Clinical Trial
The effect of cricoid pressure application on airway patency.
To assess the incidence of upper airway obstruction associated with the application of cricoid pressure (Sellick's maneuver) by experienced anesthetists. ⋯ The use of manual cricoid pressure, even by experienced anesthetists, causes a degree of airway obstruction and can cause complete airway occlusion.
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With improvements in the surgical technique for orthotopic liver transplantation, patients with significant underlying systemic disease are considered candidates for transplantation, thus increasing the complexity of the medical management of these patients and necessitating additional monitoring in order to minimize the anesthetic risk. We describe the anesthetic management of orthotopic liver transplantation for a patient with severe hypertrophic cardiomyopathy and mitral insufficiency. In this case, transesophageal echocardiography proved useful in the management of the postreperfusion period of the surgical procedure.
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To elucidate risk factors for apnea in preterm infants discharged from the hospital and in full-term healthy infants. To determine the efficacy of real-time cardiopulmonary monitoring versus computerized storage and retrieval for infants at risk. ⋯ Although it is easier to predict postoperative respiratory dysfunction in previously sick or very young infants, absolute predictability for all neonates remains elusive. Clinical monitors with both storage and retrieval capabilities and real-time monitoring increase our ability to detect significant events in children at risk for apnea after herniorrhaphy.
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To determine the incidence and severity of vomiting in pediatric patients who have had inhalation anesthesia for magnetic resonance imaging (MRI). ⋯ Protracted post-procedure vomiting is an infrequent complication of inhalation anesthesia for MRI. Inhalation anesthesia may be a less important cause of postoperative vomiting than factors such as the type of operative procedure, use of opioids, or presence of postoperative pain.
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Comparative Study
A re-evaluation of the ability of thiopental to identify cerebrospinal fluid in epidural catheter aspirate.
Sodium thiopental has been used to determine whether fluid aspirated from an epidural catheter is previously injected local anesthetic or cerebrospinal fluid (CSF). The purpose of this study was to test the efficacy of this test in distinguishing opioids from CSF. ⋯ Use of thiopental to differentiate opioids from cerebrospinal fluid is unreliable. In addition, in some simulated situations, opioids may mask the presence of local anesthetic.