Journal of clinical anesthesia
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The use of peripheral nerve blocks as the sole anesthetic, augmented with mild sedation for intraoperative management of surgery on the ankle and knee in two hemophiliac patients, is presented. Peripheral nerve blocks may be safely used for surgery of the extremities in a patient with moderate to severe hemophilia, provided a safe level of Factor VIII is maintained throughout the perioperative period.
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Randomized Controlled Trial
Efficacy of oropharyngeal lidocaine instillation on hemodynamic responses to orotracheal intubation.
To determine whether oropharyngeal instillation of lidocaine after anesthetic induction modifies the hemodynamic response to intubation. ⋯ Oropharyngeal instillation of lidocaine for three minutes before intubation attenuates the cardiovascular responses to intubation.
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Randomized Controlled Trial
Addition of midazolam to continuous postoperative epidural bupivacaine infusion reduces requirement for rescue analgesia in children undergoing upper abdominal and flank surgery.
To investigate the effect of adding midazolam to continuous epidural infusion of bupivacaine for postoperative analgesia in children. ⋯ Addition of 20 microg/kg/hr of midazolam to postoperative continuous epidural infusion of 0.125% bupivacaine reduces the requirement for rescue analgesia in children following upper abdominal and flank surgery.
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Randomized Controlled Trial Comparative Study
Comparison of fentanyl and sufentanil as adjuncts to bupivacaine for labor epidural analgesia.
To compare the clinical efficacy of theoretically equipotent doses of fentanyl and sufentanil, each in combination with bupivacaine, for patient-controlled epidural analgesia (PCEA) for labor. ⋯ At the assumed equipotent sufentanil to fentanyl ratio of 6:1, there is some evidence that sufentanil is clinically superior to fentanyl as an adjunct to bupivacaine in labor epidurals, although the advantages are subtle.
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Comparative Study
Does epidural versus combined spinal-epidural analgesia prolong labor and increase the risk of instrumental and cesarean delivery in nulliparous women?
To compare duration of labor, mode of delivery, and local anesthetic consumed in women who received labor analgesia with epidural or combined spinal-epidural technique. ⋯ No significant differences were observed between epidural and combined spinal-epidural given for labor analgesia in nulliparous women in duration of labor, mode of delivery, or local anesthetic consumed.