Journal of clinical anesthesia
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Randomized Controlled Trial Clinical Trial
The effect of cricoid pressure application on airway patency.
To assess the incidence of upper airway obstruction associated with the application of cricoid pressure (Sellick's maneuver) by experienced anesthetists. ⋯ The use of manual cricoid pressure, even by experienced anesthetists, causes a degree of airway obstruction and can cause complete airway occlusion.
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To determine the incidence and severity of vomiting in pediatric patients who have had inhalation anesthesia for magnetic resonance imaging (MRI). ⋯ Protracted post-procedure vomiting is an infrequent complication of inhalation anesthesia for MRI. Inhalation anesthesia may be a less important cause of postoperative vomiting than factors such as the type of operative procedure, use of opioids, or presence of postoperative pain.
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The anesthetic challenge of managing a difficult airway is demanding under the best of conditions. An emergency operation compounds the difficulty. Seldom do we have the opportunity to truly plan for a possible emergency. This report presents a solution to the problem of knowing of a difficult airway but having no control over the timing or possible emergent state of the operation.
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Comparative Study
A re-evaluation of the ability of thiopental to identify cerebrospinal fluid in epidural catheter aspirate.
Sodium thiopental has been used to determine whether fluid aspirated from an epidural catheter is previously injected local anesthetic or cerebrospinal fluid (CSF). The purpose of this study was to test the efficacy of this test in distinguishing opioids from CSF. ⋯ Use of thiopental to differentiate opioids from cerebrospinal fluid is unreliable. In addition, in some simulated situations, opioids may mask the presence of local anesthetic.
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Comparative Study
Cardiac output measurement: lack of agreement between thermodilution and thoracic electric bioimpedance in two clinical settings.
To determine the agreement between thermodilution (TD) and thoracic electric bioimpedance (TEB) techniques in cardiac output (CO) measurements in hyperdynamic kidney recipients and normodynamic patients subjected to radical cystectomy. The main objective was to determine the reliability of TEB in CO measurement. ⋯ These findings demonstrate lack of agreement between TEB and TD in CO measurements in a hyperdynamic and a normodynamic clinical setting. It is concluded that the TEB device is unreliable in CO measurement and cannot replace or be interchanged with TD.