Journal of clinical anesthesia
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Case Reports
Cesarean section in a pregnant patient with an anterior mediastinal mass and failed supradiaphragmatic irradiation.
Nodular sclerosing Hodgkin's disease stages IA and IIA are the most common presentation of this disease during pregnancy. Patients presenting with late Hodgkin's disease with failed irradiation for cesarean section present a unique challenge. ⋯ We report a case involving a pregnant patient at 34 weeks' gestation presenting for cesarean section with a symptomatic anterior mediastinal mass occupying over 50% of the thoracic diameter. The anesthetic management was performed using continuous spinal.
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Randomized Controlled Trial Comparative Study Clinical Trial
Desflurane controls the hemodynamic response to surgical stimulation more rapidly than isoflurane.
To compare the control of hemodynamic response to surgical stimulus of desflurane to that of isoflurane. ⋯ Anesthetic depth can be more rapidly titrated with desflurane compared to isoflurane. Alveolar/inspired concentration ratio approaches unity more rapidly with desflurane anesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Propofol-based anesthesia as compared with standard anesthetic techniques for middle ear surgery.
To determine if a total intravenous (i.v.) technique with propofol and fentanyl is superior to isoflurane anesthesia in patients undergoing middle ear surgery. ⋯ Propofol-fentanyl seems to be a better anesthetic than isoflurane-fentanyl in reducing the incidence of nausea and vomiting after middle ear surgery. Through the addition of droperidol to the isoflurane anesthetic seemed as effective, emergence from anesthesia was slower. For middle ear surgeries producing emesis, propofol-based anesthetics produced a rapid emergence with less nausea and vomiting.
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Clinical Trial
Total intravenous anesthesia for children undergoing brief diagnostic or therapeutic procedures.
To compare the quality of anesthesia with propofol, ketamine, or etomidate in children undergoing brief diagnostic or therapeutic procedures. ⋯ Anesthesia with propofol, ketamine, or etomidate is safe and efficacious for children undergoing brief procedures. Propofol is associated with a decreased incidence of postanesthetic agitation and vomiting. Its association with respiratory depression is confirmed.
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Meta Analysis
The incidence of aspiration associated with the laryngeal mask airway: a meta-analysis of published literature.
To determine the incidence of pulmonary aspiration with the laryngeal mask airway (LMA). ⋯ The evidence to date suggests that the pulmonary aspiration with the LMA is uncommon and comparable to that for outpatient anesthesia with the face mask and tracheal tube. Meticulous attention to selection of low-risk patients and appropriate operative procedures and avoidance of light anesthesia should reduce the incidence even further.