Journal of clinical anesthesia
-
Randomized Controlled Trial Comparative Study Clinical Trial
Risk of recurarization during retransfusion of autologous blood withdrawn after injection of muscle relaxants: a comparison of rocuronium and mivacurium.
In the context of acute normovolemic hemodilution (ANH) recurarization, defined as significant decrease of train-of-four ratio (TOFR) during retransfusion of autologous blood withdrawn after induction of anesthesia, has been described for vecuronium and atracurium. The present study for the first time examined this risk for rocuronium and mivacurium. ⋯ Recurarization during retransfusion may occur with both neuromuscular blocking drugs, mivacurium and rocuronium, when these drugs were injected before the removal of the autologous blood.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Ambulatory electrical external cardioversion with propofol or etomidate.
To compare, in pairwise fashion, the effects of propofol and etomidate during ambulatory cardioversion and early recovery. ⋯ Etomidate and propofol are both useful during ambulatory external electrical cardioversion. The described doses maintain stable hemodynamic conditions in nonpremedicated patients. Recovery scores and psychomotor test indicate a faster recovery in the propofol group. However, no intergroup differences were noted at 20 minutes after the cardioversion. A safe discharge of all patients from the critical care unit or postanesthesia care unit to the ward can be considered after 30 minutes.
-
Randomized Controlled Trial Clinical Trial
Wound infiltration with ropivacaine and fentanyl: effects on postoperative pain and PONV after breast surgery.
To determine whether postoperative wound infiltration with local anesthetics combined with fentanyl improves analgesia following breast surgery; and to investigate awakening and postoperative nausea/vomiting. ⋯ Postsurgical ropivacaine wound infiltration, with or without adding fentanyl, demonstrates no differences in postoperative pain relief and nausea/vomiting compared to a balanced general anesthetic including i.v. fentanyl.
-
Norepinephrine (NE) is mostly used to treat severe hypotension. However, NE has potentially adverse vasoconstrictive effects on regional vascular beds of kidney, liver, and gut, with a potential for ensuing organ dysfunction. NE therefore is considered as a last reserve in otherwise refractory hypotension. ⋯ Therefore, the doses of NE needed to maintain or restore blood pressure may be extremely high. Surprisingly, no adverse vasoconstriction with subsequent hypoperfusion occurs during sepsis, despite the high doses of NE administered. Instead, NE rather causes an increase in blood flow and oxygen delivery.
-
To investigate the effect of different plasma levels of fentanyl on the concentration of propofol and the Bispectral Index (BIS) required for patients to regain consciousness and orientation following surgery. ⋯ The plasma levels of fentanyl affect the concentrations of propofol required for patients to regain consciousness. The BIS values for wakefulness are unaltered at the different combinations of propofol and fentanyl concentrations. Thus, the BIS appears to be a useful and consistent indicator for level of consciousness during emergence from propofol/fentanyl intravenous anesthesia.