Journal of clinical anesthesia
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Randomized Controlled Trial
A pilot study of upper airway management using a remote-controlled artificial muscle device during propofol anesthesia.
To test the hypothesis that the jaw closure using a pneumatic actuator device affect airway collapsibility and resistance during propofol anesthesia. ⋯ We demonstrated that jaw closure using an air-inflatable pneumatic actuator device can produce substantial decreases in upper airway collapsibility and maintain upper airway patency during propofol anesthesia.
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Patient characteristics may affect patients' response to insulin. We examined the impact of body weight and presence of diabetes on the response to insulin during noncardiac surgery. We studied 202 patients who were enrolled in the DeLiT Trial and received intraoperative intravenous insulin. ⋯ The response to insulin was similar in patients with or without diabetes (adjusted mean difference [97.5% confidence interval], 0.2 [-3.9, 4.2] mg/dL, 0.01 [-0.22, 0.24] mmol/L; P = .93). No relationship was found between insulin response and body weight (P=0.38). Our results suggest that adjustment for body weight and the presence of diabetes may not improve intraoperative insulin treatment algorithms.
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Over the last 6 years, our center has introduced a novel technique combining peripheral nerve blocks (femoral and lateral femoral cutaneous nerves) with sedation using propofol with alfentanil target-controlled infusion for hip fracture surgery. The purpose of this review was to identify if adverse outcomes (of mortality and length of stay) were associated with its introduction compared to spinal or general anesthesia. ⋯ This novel technique does not appear to be associated with adverse mortality or length of stay after hip fracture surgery.
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Preoperative anxiety is commonly reported by people undergoing surgery. A significant number of studies have found a correlation between preoperative anxiety and post-operative morbidity. Various methods of complementary and alternative medicine (CAM) were found to be effective in alleviating preoperative anxiety. This study examined the relative effectiveness of various individual and generic CAM methods combined with standard treatment (ST) in relieving preoperative anxiety, in comparison with ST alone. ⋯ Individual CAM treatments integrated within ST reduce preoperative anxiety significantly, compared to standard treatment alone, and are more effective than generic CDRGI. In light of the scope of preoperative anxiety and its implications for public health, integration of CAM therapies with ST should be considered for reducing preoperative anxiety.
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To determine whether depth of anesthesia correlates with central pupils in outpatient infants undergoing fundus examination during general anesthesia. ⋯ Central pupils are a reliable clinical indicator to assess adequate anesthetic depth in preterm infants during sevoflurane anesthesia.