Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study
Insulin glargine dosing before next-day surgery: comparing three strategies.
To evaluate three evening insulin glargine dosing strategies for achievement of target (100-179 mg/dL; 5.5 - 9.8 mmol/L) and widened (80-249 mg/dL; 4.4 - 13.7 mmol/L) preoperative fasting blood glucose (FBG) ranges on the day of surgery. ⋯ Target preoperative FBG achievement was similar among strategies in both insulin glargine groups. An insulin glargine adjustment strategy based on usual glycemic control may better prevent severe preoperative hyperglycemia in patients receiving basal/bolus regimens.
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Meta Analysis Comparative Study
The ProSeal Laryngeal Mask Airway is more effective than the LMA-Classic in pediatric anesthesia: a meta-analysis.
To determine, in pediatric patients, whether the ProSeal Laryngeal Mask Airway (PLMA) has advantages over the LMA-Classic (cLMA) in leak pressure, placement difficulty, incidence of adverse events, postoperative blood staining, laryngospasm, bronchospasm, and hoarseness. ⋯ The PLMA (in sizes 1,1.5, 2, and 2.5) offers some advantages over the cLMA in pediatric anesthesia.
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Five patients who underwent surgery for breast cancer were followed for 6 days after placement of a multiple-injection, one-time paravertebral block. Data were collected on patient satisfaction, analgesic consumption, side effects, and complications. Ropivacaine as a sole agent in paravertebral blocks has a clinical duration of up to 6 hours. The addition of epinephrine, clonidine, and dexamethasone prolonged the clinical duration considerably.
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To describe the root causes of intraoperative hypoglycemic events. ⋯ Intraoperative hypoglycemia was rare, but often preventable. Better communication among providers and between providers and patients may reduce the number of intraoperative hypoglycemic events. Many transient episodes of hypoglycemia did not result in any apparent complications, rendering their clinical importance uncertain. Critically ill patients in circulatory shock represent a group that may require close glucose monitoring.