Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study
Entropy vs standard clinical monitoring using total intravenous anesthesia during transvaginal oocyte retrieval in patients for in vitro fertilization.
Day care surgery is an important arena for monitors of anesthetic depth where minimizing drug use is essential for rapid turnover. Underdosage, on the other hand, carries the risks of intraoperative awareness and pain. Transvaginal oocyte retrieval (TVOR), often performed under total intravenous anesthesia using propofol and fentanyl in Indian patients, is a procedure of special interest because, in addition to the above concerns, toxic effects of propofol on oocytes have been described. We have studied the role of entropy monitor, a depth of anesthesia monitor, in optomising drug titration and facilitating distinction between analgesic and hypnotic components of anesthesia. ⋯ Entropy monitor is a useful tool allowing distinction between analgesic and hypnotic components of general anesthesia in patients undergoing TVOR and facilitating drug titration accordingly. Its impact on intraoperative awareness needs to be further evaluated.
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Randomized Controlled Trial Comparative Study
Comparison of the clinical performances of Air-Qsp and i-Gel for airway management under general anesthesia with a muscle relaxant.
Recently, i-Gel intubating laryngeal airway (ILA) has been frequently used because of the ease for airway insertion by residents and young anesthesiologists. However, it sometimes fails to fit or ventilate sufficiently in Japanese patients. Use of Air-Qsp, which is a new non-inflatable cuffed ILA, in a clinical setting has become possible. The purpose of this study was to compare the clinical performance of Air-Qsp with that of i-Gel for airway management in Japanese adult patients. ⋯ Air-Qsp is as useful as i-Gel in Japanese patients and the distributions of the tips of BFs through ILAs are different for Air-Qsp and i-Gel.
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Randomized Controlled Trial Comparative Study
A randomized trial comparing prophylactic phenylephrine and ephedrine infusion during spinal anesthesia for emergency cesarean delivery in cases of acute fetal compromise.
Previous evidence showed that use of phenylephrine was associated with higher umbilical artery pH (UA pH) than ephedrine after elective cesarean delivery (CD). However, the best choice of vasopressor and its effect on funic gases in cases of acute fetal compromise require additional studies. ⋯ Our data report similar fetal acidosis with either phenylephrine or ephedrine administered during spinal anesthesia for treating maternal hypotension in cases of emergency CD.
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Randomized Controlled Trial Comparative Study
Nerve stimulator-guided pudendal nerve block vs general anesthesia for postoperative pain management after anterior and posterior vaginal wall repair: a prospective randomized trial.
Compare the effectiveness of nerve stimulator-guided pudendal nerve block (PNB) vs general anesthesia (GA) for anterior and posterior (AP) colporrhaphy in terms of pain relief and analgesic consumption within 24 and 48 hours postoperatively. ⋯ This randomized controlled trial demonstrated that nerve stimulator-guided PNB could be used as an alternative to GA for AP repair of stages I and II prolapse because it is associated with less postoperative pain and analgesic consumption, in addition to shorter duration of recovery.
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Randomized Controlled Trial Comparative Study
LMA-ProSeal insertion by novice doctors as affected by a 90° bend created by an intubating stylet: a randomized clinical trial.
This study aimed to test the hypothesis that insertion of the supraglottic device LMA-ProSeal (ProSeal) by novice doctors in anesthetized patients can be improved by using an intubating stylet to create a 90° bend and that better sealing pressure is achieved. ⋯ Our results suggest that creating a 90° bend using an intubating stylet facilitates ProSeal insertion by novice doctors, as reflected by higher successful insertion rates, higher sealing pressure, and lower subjective difficulty of insertion in anesthetized patients.