Journal of clinical anesthesia
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Comparative Study
Dexamethasone and perioperative blood glucose in patients undergoing total joint arthroplasty: A retrospective study.
Perioperative dexamethasone is commonly used to prevent nausea. It can also increase blood glucose levels, and recent concern about its blood glucose-elevating effect in humans has been raised. This study aimed to demonstrate relationships between dexamethasone administration and elevated perioperative blood glucose in patients undergoing total joint arthroplasty. ⋯ There was no evidence of an association between perioperative dexamethasone administration and the odds of having postoperative glucose levels >200mg/dl or higher maximum glucose levels. However, these findings may not be generalizable to patients having different baseline characteristics or procedures.
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Randomized Controlled Trial
The effect of play distraction on anxiety before premedication administration: a randomized trial.
The majority of children scheduled to undergo surgery experience substantial anxiety in the preoperative holding area before induction of anesthesia. Pharmacological interventions aimed at reducing perioperative anxiety are paradoxically a source of stress for children themselves. Midazolam is frequently used as premedication, and the formula of this drug in Turkey is bitter. We aimed to assess the role of distraction in the form of playing with play dough (Play-Doh) on reducing premedication anxiety in children. ⋯ This study showed that distraction in the form of playing with play dough facilitated administration of oral midazolam in young children.
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Randomized Controlled Trial
Oblique approach for ultrasound-guided radial artery catheterization vs transverse and longitudinal approaches, a randomized trial.
To investigate the value of using a new technique for ultrasound-guided radial artery catheterization; oblique approach; vs transverse and longitudinal views are the traditionally used approaches aiming to combine benefits and avoid drawbacks of aforementioned approaches. ⋯ These results support the conclusion that the oblique approach for US-guided radial artery catheterization may replace the 2 classic approaches owing to its superior success rate, higher first attempt success and shorter time consumed for catheterization with more operator satisfaction after the procedure.
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Controlled Clinical Trial
Minimum effective fluid volume of colloid to prevent hypotension during caesarean section under spinal anesthesia using a prophylactic phenylephrine infusion: An up-down sequential allocation study.
The aim of this study was to de termine the minimum effective fluid volume (MEFV) of hydroxyethyl starch 130/0.4 (HES) infused in a preload fashion which would prevent hypotension in 50% of parturients undergoing caesarean section. A secondary objective was to measure the hemodynamic effect of fluid loading on the subjects. ⋯ Our study is the first to investigate variable fluid loading volumes in this population. A HES preload of approximatively 700 mL prevented maternal hypotension in 50% of the parturients under the conditions of this study. We suggest that up-down sequential allocation design is a useful tool to compare different fluid loading regimens in this setting.
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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.