Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Adaptive feedback-controlled infusion versus repetitive injections of vecuronium in patients during isoflurane anesthesia.
To compare vecuronium requirements using repetitive injections and a model-based, closed-loop, feedback-controlled infusion during isoflurane anesthesia. ⋯ The model-based adaptive feedback system proved to be useful in maintaining a stable degree of paralysis, adjusting relaxant input to individual demand, and minimizing drug requirement, as compared with repetitive injections.
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Randomized Controlled Trial Clinical Trial
The clinical effectiveness of epidural bupivacaine, bupivacaine with lidocaine, and bupivacaine with fentanyl for labor analgesia.
To examine the efficacy of bupivacaine alone and in combination with lidocaine or fentanyl for epidural analgesia during labor. ⋯ Epidurally administered fentanyl safely extended the duration of labor analgesia while reducing bupivacaine dose requirements and magnitude of motor block. In this setting, the combination of bupivacaine and lidocaine offered no clinical advantage over bupivacaine alone.
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A 25-year-old healthy patient developed bilateral tension pneumothorax during general endotracheal anesthesia due to a defective anesthesia breathing circuit filter. Prompt diagnosis and treatment of the pneumothorax was facilitated by the use of capnography and pulse oximetry. The manufacturing process of the breathing circuit and filter that made this accident possible has since been corrected by the manufacturer. Anesthesiologists must be alert to the possibility of such accidents with any breathing system using bacterial filters.
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The purpose of the study was to determine whether epidural analgesia is unsafe for trial of labor (TOL). ⋯ Uterine rupture presents as monitored fetal distress rather than abdominal pain. Thus, epidural analgesia can be used in patients attempting a TOL.