Journal of clinical anesthesia
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Observational Study
Airway management for glossopexy in infants with micrognathia and obstructive breathing.
To identify airway management and tracheal intubation techniques for glossopexy in infants with preexisting airway obstruction under general anesthesia. ⋯ There are severe cases of infants with difficult mask ventilation and difficult tracheal intubation in which a fiberscope is required because video laryngoscopy fails to improve the view of the larynx.
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Observational Study
Effect of basal insulin dosage on blood glucose concentration in ambulatory surgery patients with type 2 diabetes.
Among patients with type 2 diabetes treated with insulin, perioperative hyperglycemia and hypoglycemia may cause undesirable symptoms, surgery delay or cancellation, or unexpected hospitalization. Our objective was to compare preoperative glargine dosing regimens on perioperative glycemic control in patients undergoing ambulatory surgery. ⋯ Our study shows that the percent of normal insulin dose given the evening before surgery directly impacts perioperative glucose levels in ambulatory surgery patients. Patients taking 60%-87% of their usual dose the evening before surgery were likely to arrive in target blood glucose range with decreased risk for hypoglycemia. The mean and mode dose taken in Group 3 were 73% and 75%, respectively, suggesting that the optimal dose may be 75% of normal dose.
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Randomized Controlled Trial
Effects of dexmedetomidine administered for postoperative analgesia on sleep quality in patients undergoing abdominal hysterectomy.
To evaluate the effects of postoperative dexmedetomidine infusion on sleep quality in patients undergoing abdominal hysterectomy. ⋯ Dexmedetomidine infusion not only offers effective analgesia but also improves postoperative sleep quality in patients undergoing hysterectomy.
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Comparative Study Clinical Trial
Cardiac output changes with phenylephrine and ephedrine infusions during spinal anesthesia for cesarean section: A randomized, double-blind trial.
Hypotension is a common side effect of spinal anesthesia. Phenylephrine and ephedrine are the two most frequently used vasopressors to treat spinal hypotension during cesarean delivery. In this randomized double-blind study, we aimed to evaluate cardiac output (CO) changes with phenylephrine or ephedrine infusions titrated to maintain baseline systolic blood pressure (bSBP) during spinal anesthesia. ⋯ The maximum increase in CO from the baseline was 12%, in the ephedrine group, and this occurred 20 minutes after spinal injection. Cardiac output fell by more than 17% in the phenylephrine group, maximal at 10 minutes following spinal injection. Despite good systolic blood pressure control and increased cardiac output with ephedrine, administration of ephedrine was associated with significantly more fetal acidosis [Median (Interquartile range, IQR) UApH - phenylephrine = 7.33 (7.31-7.34) and ephedrine = 7.22 (7.16-7.27), P < .05].
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To assess the usefulness of the new NEMA (Neck Circumference Minus Acromion-Acromion Distance) parameter, in preoperative identification of patients' difficult intubation and compare it with other commonly used scales and tests. ⋯ It seems that none of the known bedside tests for predicting difficult intubation have a discriminating power sufficient for clinicians. Our study draws attention to a novel parameter, called NEMA, which appears to be a strong predictor of DEI, especially in combination with the Mallampati scale.