Journal of clinical anesthesia
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Randomized Controlled Trial Multicenter Study Clinical Trial
Etomidate and thiopental-based anesthetic induction: comparisons between different titrated levels of electrophysiologic cortical depression and response to laryngoscopy.
To determine whether etomidate-based induction can provide better hemodynamics than a standard thiopental sodium-based anesthetic induction. ⋯ Etomidate-based anesthetic induction, titrated to EEG burst suppression, produced stable hemodynamics during laryngoscopy and intubation as compared with lower dose, more "classic" inductions with etomidate or thiopental.
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Randomized Controlled Trial Comparative Study Clinical Trial
Postoperative analgesia using a low-dose, oral-transdermal clonidine combination: lack of clinical efficacy.
To determine if a lower than previously reported oral-transdermal clonidine regimen could reduce postoperative morphine requirements without producing systemic side effects. ⋯ The low-dose oral-transdermal clonidine regimen evaluated failed to reduce postoperative morphine requirements, although patients who received clonidine were still at risk for developing hypotension.
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Randomized Controlled Trial Clinical Trial
Effect of propofol for induction and ondansetron with or without dexamethasone for the prevention of nausea and vomiting after major gynecologic surgery.
To test the hypothesis that for major gynecologic surgery the combination of propofol for induction, ondansetron, and dexamethasone would be a more effective antiemetic combination than propofol for induction, ondansetron, and saline; and to determine if a propofol induction of anesthesia improved our previously reported results when thiamylal was the induction drug. ⋯ The hypothesis that the addition of dexamethasone to the propofolondansetron combination would significantly reduce postoperative nausea and vomiting (PONV) was not confirmed. A propofol induction of anesthesia resulted in a comparable incidence of PONV when compared with our previously reported results using thiamylal for induction of anesthesia for women having major gynecologic operations.
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Clinical Trial
Heart rate, heart rate variability, and blood pressure during perioperative stressor events in abdominal surgery.
To define the behavior of power spectral heart rate variability (PSHR) during potentially stressful events in the perioperative period, and relate it to changes in blood pressure (BP) and heart rate (HR). ⋯ On anesthetic induction, preoperative, but not intraoperative, spectral indices were predictive of BP changes. Power spectral analysis of HR may provide information about the autonomic state that is not evident from BP or HR. The HR power spectrum, in particular, indicated a striking autonomic imbalance immediately after the induction of anesthesia despite stable HR and BP. LFA and LFA/RFA ratio appeared to track sympathetic autonomic activation during abdominal surgical stimulation, but not during other perioperative stressor events.
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Letter Case Reports
Post-dural puncture headache and epidural blood patch in an AIDS patient.