Journal of clinical anesthesia
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Pain is one of the main postoperative adverse outcomes. Single analgesics, either opioid or nonsteroidal antiinflammatory drugs (NSAIDs), are not able to provide effective pain relief without side effects such as nausea, vomiting, sedation, or bleeding. A majority of double or single-blind studies investigating the use of NSAIDs and opioid analgesics with or without local anesthetic infiltration showed that patients experience lower pain scores, need fewer analgesics, and have a prolonged time to requiring analgesics after surgery. This review focuses on multimodal analgesia, which is currently recommended for effective postoperative pain control.
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Randomized Controlled Trial Clinical Trial
Atropine prevents midazolam-induced core hypothermia in elderly patients.
To test the hypothesis that core temperature is well preserved when atropine and midazolam are combined. ⋯ The thermoregulatory effects of benzodiazepine receptor agonist and cholinergic inhibitors oppose each other, and the combination leaves core temperature unchanged.
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To evaluate the effect of positive end-expiratory pressure (PEEP) and continuous positive airway pressure (CPAP) on the oxygenation and shunt fraction during one-lung ventilation (OLV). ⋯ The application of PEEP to the dependent lung, CPAP to the nondependent lung, and the combination of PEEP and CPAP, are useful for improving oxygenation and decreasing Qs/Qt.
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To investigate changes that most surgical suites will need to make in the process of giving reports to family members on the day of surgery by the compliance date (April 14, 2003) of the privacy regulations of the Health Insurance Portability and Accountability Act (HIPPA) of 1996. ⋯ Surgical facilities should strive to provide in-person progress reports to family members while their relatives are undergoing surgery. To satisfy HIPAA regulations, the staff and physicians who talk to family members in the waiting room will need to determine first if the patient has agreed to the release of information. As hospital information systems are updated to assure that this process is HIPAA-compliant, facilities can also incorporate the relevant statistical methods.
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Randomized Controlled Trial Clinical Trial
Severity of airway hyperreactivity associated with laryngeal mask airway removal: correlation with volatile anesthetic choice and depth of anesthesia.
To compare the influence of anesthetic depth and choice of volatile anesthetic drug on the incidence and severity of airway hyperreactivity associated with Laryngeal Mask Airway (LMA) removal. ⋯ Depth of anesthesia during LMA removal does not appear to affect the incidence or severity of airway hyperreactivity when sevoflurane is the maintenance anesthetic. However, awake LMA removal during isoflurane anesthesia results in a higher incidence of adverse airway events and carries the risk of severe airway hyperreactivity.