Journal of clinical anesthesia
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Randomized Controlled Trial Clinical Trial
Clinical pharmacokinetics of propofol given as a constant-rate infusion and in combination with epidural blockade.
To investigate the pharmacokinetics of propofol in combination with epidural anesthesia or with intravenous (i.v.) alfentanil infusion, and to investigate the clinical feasibility of this anesthetic technique in lower abdominal surgery. ⋯ We could not show any statistically significant influence of an epidural blockade on the pharmacokinetic parameters of propofol. Nevertheless, the concentration-time profile changed during infusion, rendering the described infusion regimen, in combination with epidural anesthesia, unsatisfactory for adequate hypnosis. The propofol infusion regimen combined with alfentanil provided immediate and stable blood concentrations that were adequate for surgery.
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To determine the frequency of true and false alarms and to determine the frequency of alarm failures for various parameters when using a postanesthesia monitoring system. ⋯ The high frequency of apnea strongly motivates the use of continuous RR monitoring, preferably by flow-sensing techniques, since both central and obstructive apneas are then detected. Further study and development is necessary before pulse oximetry can be unconditionally recommended for postanesthesia monitoring.
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To evaluate the relative contribution of general anesthesia alone and in combination with the surgical procedure to the pathogenesis of late postoperative hypoxemia. ⋯ General anesthesia in itself is not an important factor in the development of late postoperative constant and episodic hypoxemia, which instead may be related to the magnitude of trauma and/or opioid administration.