Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Influence of intravenous clonidine pretreatment on anesthetic requirements during bispectral EEG-guided sevoflurane anesthesia.
To assess the anesthetic effects of clonidine during sevoflurane anesthesia guided by the bispectral index (BIS), which is a processed EEG variable correlated with anesthetic-hypnotic depth. ⋯ Mean sevoflurane requirements were not lower with clonidine pretreatment. There was statistically better perioperative hemodynamic stability (i.e., fewer episodes of hypertension and tachycardia) without clinical relevance. A decreased need for postoperative analgesia was observed.
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Comparative Study
Effects of epidural anesthesia on the cardiovascular response to a rapid increase in isoflurane concentration.
To compare circulatory variables to an abrupt increase in isoflurance concentration via mask in patients who received either upper thoracic or lumbar epidural anesthesia, or neither. ⋯ Epidural anesthesia can blunt circulatory responses to a sudden increase in isoflurane concentration.
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A case of advanced cryptogenic fibrosing alveolitis (CFA) with multiple bullae and extensive pulmonary fibrosis, scheduled for modified radical mastectomy for carcinoma of breast, is presented. This patient had ischemic heart disease, corticosteroid-induced hypertension, diabetes mellitus, and a difficult airway. Thoracic epidural segmental anesthesia was successfully given to this patient. Preoperative problems, perioperative management, and alternative anesthetic techniques are discussed.
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Case Reports
Cardiac arrest due to succinylcholine-induced hyperkalemia in a patient with wound botulism.
Cardiac arrest due to hyperkalemia is a known complication of succinylcholine administration in patients with neuromuscular disease, extensive burns, and prolonged immobility. We report a case of hyperkalemic cardiac arrest following the administration of succinylcholine in a patient suffering from wound botulism.
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Comparative Study
Comparison of acute normovolemic hemodilution and preoperative autologous blood donation in clinical practice.
To compare, by model simulation, acute normovolemic hemodilution (ANH) and preoperative autologous blood donation (PABD) to predict their efficacy in current clinical practice. To discuss their similarities and offer guidelines based on expected operative blood loss. ⋯ PABD exemplifies a "chronic" form of ANH in current clinical practice and offers little advantage over ANH as a blood conservation technique for high-blood-loss operations. When surgical blood loss is predictably mild to moderate (range 250 to 1,000 mL), neither blood conservation technique is necessary.