Journal of clinical anesthesia
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Randomized Controlled Trial
A dose study of remifentanil in combination with propofol during tracheobronchial foreign body removal in children.
To assess the effect of two different remifentanil infusion doses on hemodynamic stability and recovery characteristics in children undergoing tracheobronchial foreign body removal during rigid bronchoscopy. ⋯ A remifentanil 0.2 μg/kg/min infusion with propofol provides hemodynamic stability and early recovery in children undergoing foreign body removal during rigid bronchoscopy.
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Randomized Controlled Trial Comparative Study
Comparison of the recovery and respiratory effects of aminophylline and doxapram following total intravenous anesthesia with propofol and remifentanil.
To compare the effects of aminophylline and doxapram on recovery, respiration, and bispectral index (BIS) values in patients after total intravenous anesthesia (TIVA) with propofol and remifentanil. ⋯ Aminophylline 3 mg/kg or doxapram 1 mg/kg shortened the time to spontaneous ventilation and improved early recovery from TIVA without appreciable side effects. The more rapid emergence correlates with higher BIS values when compared with the saline control group. The arousal and respiratory effects of aminophylline were comparable to those of doxapram.
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Randomized Controlled Trial
Effect of preemptive and preventive acetaminophen on postoperative pain score: a randomized, double-blind trial of patients undergoing lower extremity surgery.
To compare postoperative pain scores and rescue analgesic use in patients who received acetaminophen preoperatively or during skin closure versus those who received a placebo. ⋯ In patients undergoing lower extremity surgery with spinal anesthesia, both preventive and preemptive acetaminophen may enhance analgesia and decrease postoperative analgesic consumption.
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Bilateral total knee replacement is becoming one of the more commonly performed orthopedic procedures for patients with advanced arthritis of both knees. The surgeon may decide to operate on both knees simultaneously, sequentially, or in a staged manner. The safety of this procedure is still debated due to wide variation in the studies and their endpoints. Although there are advantages with bilateral procedures such as reduced cost and improved rehabilitation, there is definite evidence of increased cardiopulmonary, thromboembolic, neurological, bleeding, and transfusion complications with bilateral knee replacement versus unilateral knee replacement, particularly in elderly patients with comorbidities.