Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study
A comparison of King Vision video laryngoscopy and direct laryngoscopy as performed by residents: a randomized controlled trial.
For more than 40 years, direct laryngoscopy (DL) has been used to assure the airway during endotracheal intubation. The King Vision video laryngoscope is one of the latest devices introduced for endotracheal intubation. We hypothesize that, relative to direct laryngoscopy, it improves the intubation success rate with fewer intubation attempts and no difference in intubation time or complications. ⋯ The use of KVVL by residents with less than 1 year of training (considered nonexperts) significantly improves visualization of the glottis in patients without predictors of difficult airway. The incidence of complications was too low to draw conclusions.
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To review the clinical and basic science literature regarding Zika viral illness and highlight relevant findings for obstetric anesthesiologists. This review provides a global review of Zika viral illness, transmission patterns, pathophysiology of disease, and anesthetic management of the parturient with Zika viral illness and associated comorbidities. ⋯ With the rapid spread of Zika virus and expected increase of spread in the summer of 2016, this review provides anesthesiologists with current recommendations, physiologic alterations, and anesthetic considerations in regard to the parturient with Zika viral illness and associated diseases.
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Comparative Study
Comparison of a new visual stylet (Discopo)-guided laryngeal mask airway placement vs conventional blind technique: a prospective randomized study.
To compare the ease of laryngeal mask airway (LMA) insertion and fiberoptic view of LMA after placement using the Discopo visual stylet-guided insertion and conventional blind technique. ⋯ By direct visualizing the whole process of LMA insertion, the Discopo visual stylet increases the success rate and accuracy rate of LMA placement without increasing hemodynamic stress response or incidences of adverse events.
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Randomized Controlled Trial
Dose requirements of alfentanil to eliminate autonomic responses during rapid-sequence induction with thiopental 4 mg/kg and rocuronium 0.6 mg/kg.
Opioids are integral part of anesthesia induction, but information on optimal dosing is limited. We aimed to determine doses of alfentanil needed to eliminate increases in 5 autonomic response variables (plasma concentrations of epinephrine, norepinephrine and vasopressin, arterial blood pressure [ABP], and heart rate) during rapid-sequence induction of anesthesia with thiopental 4 mg/kg and rocuronium 0.6 mg/kg. ⋯ Optimal control of autonomic responses during rapid-sequence induction was achieved with clinically relevant doses of alfentanil in healthy patients anesthetized with thiopental 4 mg/kg and rocuronium 0.6 mg/kg.
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Observational Study
Preoperative depressed mood and perioperative heart rate variability in patients with hepatic cancer.
How perioperative heart rate variability (HRV) indices differ according to the anxiety or depressed mood of patients scheduled to undergo a major surgical procedure for cancer. ⋯ HRV decreased significantly immediately before anesthesia and recovered to baseline with anesthetic induction. Preoperative, more depressed patients showed increased sympathetic tone at baseline and blunted response to impending anesthesia on the HRV measurements.