Journal of clinical anesthesia
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Randomized Controlled Trial
The influence of patient position on withdrawal force of lumbar epidural catheters after total knee arthroplasty: A randomized trial.
Elderly patients with degenerative knee disease may have accompanying degenerative spine conditions. There are no studies on lumbar epidural catheter withdrawal forces in these patients. The aim of this study was to investigate withdrawal forces and possible associated risk factors in patients undergoing total knee arthroplasty (TKA). ⋯ For ease of removal of catheters from the lumbar epidural space, the flexed lateral position is recommended for elderly patients undergoing TKA. When placing the epidural catheter, the physician should be careful not to insert a catheter that is excessively long.
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Randomized Controlled Trial Comparative Study
Comparison of esophageal Doppler and plethysmographic variability index to guide intraoperative fluid therapy for low-risk patients undergoing colorectal surgery.
This study aims to investigate if there is equivalence in volumes of fluid administered when intravenous fluid therapy is guided by Pleth Variability Index (PVI) compared to the established technology of esophageal Doppler in low-risk patients undergoing major colorectal surgery. ⋯ PVI offers an entirely non-invasive alternative for goal-directed fluid therapy in this group of patients.
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Randomized Controlled Trial Comparative Study
Analgesic efficacy of pregabalin in acute postmastectomy pain: placebo controlled dose ranging study.
We hypothesized that oral administration of a single dose of pregabalin 2 hours before modified radical mastectomy (MRM) would produce dose-related reduction in postoperative opioid consumption. ⋯ A single preoperative oral dose of pregabalin 150 mg is an optimal dose for reducing postoperative pain and morphine consumption in patients undergoing MRM.
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Case Reports
Real-time measurement of blood pressure with Nexfin in a patient with thalidomide-related phocomelia.
We report the novel application of photoplethysmographic technology with the Nexfin HD monitor for real-time measurement of blood pressure (BP) in a patient with tetraamelia. The patient was a 58-year-old man with tetraamelia secondary to thalidomide exposure in utero, who presented for surgical excision of a maxillary schwannoma. Because difficulty of cuff use on rudimentary limbs and failure to gain invasive arterial access due to abnormalities of limb vasculature, this population is known to pose some unique challenges for BP measurement. Nexfin may offer an alternative noninvasive method to detect BP in patients with phocomelia during the perioperative period.
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Comparative Study
King Vision video laryngoscope versus Lightwand as an intubating device in adult patients with Mallampatti grade III and IV patients.
Anticipated and unanticipated difficult airways are often encountered by anesthesiologists in their clinical practice. There are various devices available in such situations. We aim to compare King Vision video laryngoscope and Lightwand for their performance as an intubating device in predicted difficult intubation. ⋯ Mean intubation time using King Vision video laryngoscope (19.50±6.73 seconds was lower than the intubation time using Lightwand 25.40±7.42 s, P=.00). The difference between number of attempts, success of intubation, numbers of adjustment maneuvers were comparable. There was a significant rise in heart rate within the groups from the pre-induction values. However inter group variations were similar. In addition, there was a significant rise in mean arterial pressure within the groups from the pre-induction values. Inter group variations show less increase in mean arterial pressure with Lightwand at immediate post intubation (P=.0234) and at 3 min and 5 min post intubation anesthesia.