Journal of clinical anesthesia
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To evaluate current practice in preoperative testing of healthy children undergoing elective surgery that is not expected to result in significant blood loss. ⋯ The results indicate the present practice of routine preoperative laboratory testing for children undergoing elective outpatient surgery. In spite of the many studies that indicate no specific benefits of performing routine preoperative testing in healthy children undergoing scheduled surgery, many physicians continue to order these tests in all such children.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Comparison of 0.25% ropivacaine and bupivacaine for epidural analgesia for labor and vaginal delivery.
Part 1: To measure ropivacaine levels in the mother and infant at delivery after continuous lumbar epidural infusion. Part 2: To compare epidural ropivacaine to epidural bupivacaine for labor analgesia in regard to effectiveness, motor blockade, and maternal and neonatal effects. ⋯ Both ropivacaine and bupivacaine produced excellent analgesia for labor with no major adverse effect on the mother or neonate.
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Randomized Controlled Trial Comparative Study Clinical Trial
Remifentanil versus alfentanil in a balanced anesthetic technique for total abdominal hysterectomy.
To compare the intraoperative effects and recovery characteristics of remifentanil hydrochloride and alfentanil when administered as part of balanced anesthesia, and to assess the effects of an additional remifentanil infusion administered as analgesic pretreatment before removal of the uterus. ⋯ A mean remifentanil infusion of 0.49 microgram/kg/min is as effective as a mean alfentanil infusion of 1.99 micrograms/kg/min in suppressing intraoperative responses. Doubling of the remifentanil infusion to 0.5 microgram/kg/min before the major stress event improves suppression of responses and lowers intraoperative use of remifentanil without prolonging recovery times. Remifentanil allows faster awakening times than alfentanil, but preemptive administration of postoperative analgesics is recommended to facilitate discharge.
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Randomized Controlled Trial Clinical Trial
Intubation in children after 0.3 mg/kg of mivacurium.
To distinguish among potential predictors of early, easy intubation in children, including apnea, neuromuscular block at two sites, and time, after administration of 0.3 mg/kg of mivacurium. ⋯ In children, there is no advantage to monitoring neuromuscular function at the OO rather than the AP. After administration of 0.3 mg/kg of mivacurium, a 90-second interval before the start of intubation was a better predictor of good intubation conditions during halothane anesthesia (1% inspired) than were changes in evoked neuromuscular function.
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Randomized Controlled Trial Clinical Trial
Effectiveness of bupivacaine administered via femoral nerve catheter for pain control after anterior cruciate ligament repair.
To evaluate the quality of pain control achieved with continuous local anesthetic infusion via a femoral nerve catheter, and to determine the optimum concentration of bupivacaine necessary to maintain pain control after full surgical anesthesia is established with 0.5% bupivacaine. ⋯ Low concentrations of bupivacaine delivered via femoral nerve catheter after an established femoral nerve block can provide excellent postoperative pain control after ACL reconstruction.