Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study
The effects of caudal or intravenous dexmedetomidine on postoperative analgesia produced by caudal bupivacaine in children: a randomized controlled double-blinded study.
The aim of this study was to compare the effects of caudal and intravenous (IV) dexmedetomidine (1 μg/kg) on postoperative analgesia after caudal bupivacaine in pediatric patients undergoing lower abdominal and perineal surgeries. ⋯ Compared to IV administration, caudal administration of dexmedetomidine during caudal bupivacaine anesthesia provided prolonged postoperative analgesia and a greater analgesic sparing effect without significant side effects. This suggests a greater role of neuraxial compared to that of peripheral α-2 adrenoceptors in pain processing.
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Randomized Controlled Trial Comparative Study
A comparison of classic laryngeal mask airway insertion between lightwand- and standard index finger-guided techniques.
To compare the efficacy of lightwand-guided classic laryngeal mask airway (cLMA) real-time insertion technique with the standard recommended index finger-guided insertion technique. ⋯ Lightwand-guided cLMA insertion technique can provide a more objective indicator for correct cLMA positioning, higher first attempt success rates, better glottic views, and less damage to oropharyngeal or esophagus tissues than standard index finger-guided cLMA insertion technique.
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Randomized Controlled Trial
Randomized study of postcesarean analgesia with intrathecal morphine alone or combined with clonidine.
To investigate the efficacy of the combination of intrathecal morphine with clonidine in comparison with 2 doses of intrathecal morphine alone for postcesarean analgesia. ⋯ At these doses, there was no benefit of associating clonidine with morphine to improve postcesarean analgesia. Considering that higher doses of morphine were associated with more side effects, 50 μg of intrathecal morphine alone seems to be a better option for analgesia. The use of clonidine to reduce postoperative shivering must be balanced against the potential risks of hypotension, bradycardia, dizziness, and sedation.
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Randomized Controlled Trial Comparative Study
Ultrashort acting remifentanil is not superior to long-acting sufentanil in preserving cognitive function-a randomized study.
Postoperative cognitive dysfunction (POCD) is a well-known complication after cardiac surgery and may cause permanent disabilities with severe consequences for quality of life. The objectives of this study were, first, to estimate the frequency of POCD after on-pump cardiac surgery in patients randomized to remifentanil- or sufentanil-based anesthesia and, second, to evaluate the association between POCD and quality of recovery and perioperative hemodynamics, respectively. ⋯ We could not demonstrate differences in POCD between remifentanil and sufentanil based anaesthesia, but in general, the fraction of patients with POCD seemed smaller than previously reported. We found an association between POCD and both perioperative low Svo2 and postoperative ventilation time, underlining the importance of perioperative stable hemodynamics and possible fast-track protocols with short ventilation times to attenuate POCD.
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To evaluate the available data describing the use of single and double lumen VivaSight tubes. ⋯ Problems such as overheating and melting on the distal end of the tube due to the light source and potential breakdowns of the cable should be solved by the manufacturer. This will probably require a redesign and necessitate further studies.