Journal of clinical anesthesia
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The purpose of this study is to determine the efficacy and safety of sedation/analgesia using a mixture of propofol, alfentanil, and lidocaine. ⋯ Adjusted for age and weight, the dose of the 6-2-2 mixture met the sedation requirements for most patients. With a low incidence of need for airway support, no pain during infusion, and no N/V, this novel mixture of propofol, alfentanil, and lidocaine provided adequate analgesia and sedation as well as hemodynamic stability for ophthalmic surgery under regional block.
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Randomized Controlled Trial Comparative Study
Remifentanil pretreatment reduces myoclonus after etomidate.
The aim of the study was to compare the effect of pretreatment with remifentanil 1 microg/kg and the effect of gender on the incidence of myoclonus after anesthesia induction with etomidate. ⋯ Pretreatment with remifentanil 1 microg/kg reduced myoclonus after etomidate induction without side effects such as sedation, apnea, nausea, or pruritus. Men experience increased incidence of myoclonus than women after etomidate administration.
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Meta Analysis
The effect of neuraxial blocks on surgical blood loss and blood transfusion requirements: a meta-analysis.
The aim of this study was to evaluate the effect of neuraxial blocks on surgical blood losses and on the number of patients requiring blood transfusion. ⋯ Regional anesthesia reduced the number of transfused patients for total hip replacement (P = 0.0009) and spinal fusion (P = 0.04). A reduction of measured blood loss that did not lead to a reduction in the number of transfused patients was also found for fractured hip surgery (P < 0.0001), lumbar disk surgery (P = 0.01), peripheral vascular surgery (P = 0.03), retropubic prostatectomy (P = 0.02), cesarean section (P < 0.0001), and bowel surgery (P = 0.0008). In summary neuraxial blocks have a clear and definite effect on surgical blood loss, but this effect do not usually lead to a reduction in the number of transfused patients except for patients undergoing total hip replacement and spinal fusion.
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Little information is available regarding the sensitivity to neuromuscular blocking drugs in patients with spinocerebellar degeneration and associated diseases. We report the response to vecuronium in a patient with late cerebellar cortical atrophy, a nonhereditary type of cerebellar ataxia. ⋯ Recovery index was 27 minutes. We believe this is the first report describing a response to neuromuscular blocking drugs in this disease.
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Preoperative risk factors for pulmonary aspiration of gastric contents during anesthesia are well studied. There is lack of information as to factors or circumstances leading to aspiration. ⋯ This study confirms that pulmonary aspiration of gastric contents is a rare complication during modern anesthesia. Preoperative risk factor was present in most patients who had pulmonary aspiration. A clear understanding of risk factor/s is needed to prevent further cases of pulmonary aspiration.