Journal of clinical anesthesia
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Randomized Controlled Trial
Autonomic activity during dexmedetomidine or fentanyl infusion with desflurane anesthesia.
To evaluate autonomic activity with dexmedetomidine or fentanyl infusion and desflurane anesthesia during laparoscopic gastric banding. ⋯ Both dexmedetomidine and fentanyl facilitated anesthesia and attenuated autonomic activity. Dexmedetomidine produced a greater decrease in sympathovagal balance than fentanyl.
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A young, healthy adult man exhibited naloxone-reversible, prolonged apnea after a 4-hour infusion of remifentanil, which was used as the opioid component of a general endotracheal anesthetic. Clinical experience and pharmacokinetic simulations indicate that the apnea was clearly atypical.
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To evaluate patient acceptability of continued versus divided anesthetic care. ⋯ Before their operations, more than half of the patients felt it very important that they were visited and anesthetized by the same physician. Nevertheless, postoperative patient satisfaction was equally high regardless of whether they were anesthetized by the same physician who had visited them preoperatively.
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To determine the frequency of complications and outcomes of urgent intubations in general hospital units. ⋯ Endotracheal intubation in general hospital units carries a high rate of complications, and patients who are intubated in general hospital units have a high mortality.
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Horner's syndrome is a potential, albeit rare, feature of continuous infraclavicular brachial plexus local anesthetics infusion, mainly the result of anatomical considerations. Horner's syndrome may be described as an "unpleasant side effect" because it has no clinical consequences in itself. Nevertheless, patient discomfort and anxiety may reduce acceptance of the analgesic technique. Reassurance and close clinical monitoring of the patient are essential to enhance patient's safety and acceptance of the technique.