Journal of clinical anesthesia
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Randomized Controlled Trial Clinical Trial
Preoperative combined with intraoperative skin-surface warming avoids hypothermia caused by general anesthesia and surgery.
To evaluate the effects of intraoperative skin-surface warming with and without 1 hour of preoperative warming, in preventing intraoperative hypothermia, and postoperative hypothermia, and shivering, and in offering good conditions to early tracheal extubation. ⋯ One hour of preoperative warning combined with intraoperative skin-surface warming, not simply intraoperative warming alone, avoided hypothermia caused by general anesthesia during the first two hours of surgery. Both methods prevented postoperative hypothermia and shivering and offered good conditions for early tracheal extubation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Intraoperative epidural anesthesia and postoperative analgesia with levobupivacaine for major orthopedic surgery: a double-blind, randomized comparison of racemic bupivacaine and ropivacaine.
To compare the onset time and duration of epidural anesthesia, and the quality of postoperative analgesia produced by levobupivacaine, racemic bupivacaine, and ropivacaine. ⋯ Levobupivacaine 0.5% produces an epidural block of similar onset, quality, and duration as the one produced by the same volume of 0.5% bupivacaine, with a motor block deeper than that produced by 0.5% ropivacaine. When prolonging the block for the first 12 hours after surgery with a patient-controlled epidural infusion, 0.125% levobupivacaine provides adequate pain relief after major orthopedic surgery, with similar recovery of motor function as compared with 0.125% bupivacaine and 0.2% ropivacaine.
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Randomized Controlled Trial Comparative Study Clinical Trial
Hemodynamic and catecholamine response to tracheal intubation: direct laryngoscopy compared with fiberoptic intubation.
To compare the stress response following tracheal intubation using direct laryngoscopy to that using fiberoptic bronchoscopy technique. ⋯ The use of either direct laryngoscopy or fiberoptic bronchoscopy produces a comparable stress response to tracheal intubation. Catecholamine levels do not correlate with the hemodynamic changes.
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Case Reports
Transpleural subclavian central venous catheter placement in a child with scoliosis discovered during a thoracotomy.
Placement of central venous catheters in dysmorphic children can be difficult because of distortion of normal anatomical landmarks. We present such a case of a 16 year-old child who had a central venous catheter inserted in the left subclavian vein. Although a conventional roentgenogram was consistent with correct placement, the catheter was found to traverse the pleural space before entering the subclavian vein.
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Randomized Controlled Trial Comparative Study Clinical Trial
Sevoflurane requirements during coloproctologic surgery: difference between two different epidural regimens.
To examine the influence of epidural morphine on the end-tidal sevoflurane concentration titrated to maintain bispectral index (BIS) values between 40 and 50. ⋯ Adding morphine to the bupivacaine epidural solution did not reduce sevoflurane requirements but did provide high-quality postoperative analgesia, mainly just after tracheal extubation.