Journal of clinical anesthesia
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Comparative Study Clinical Trial Controlled Clinical Trial
Superiority of multi-orifice over single-orifice epidural catheters for labor analgesia and cesarean delivery.
To investigate whether a change from a single-orifice to multi-orifice catheter could reduce the incidence of inadequate epidural blocks requiring replacement of the epidural catheter in obstetric patients. ⋯ The multi-orifice design offers significant advantages over the single-orifice type for obstetricepidural analgesia.
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Comparative Study Clinical Trial
A comparison of propofol and remifentanil during monitored anesthesia care.
To compare remifentanil, an esterase-metabolized opioid, to a standard propofol-based sedation technique for monitored anesthesia care (MAC). ⋯ Remifentanil provided comparable intraoperative conditions and patient comfort at a lower sedation level compared with propofol. However, remifentanil was associated with greater respiratory depression and a longer time to home readiness.
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To obtain data about the safety and efficacy of the size 5 laryngeal mask airway (LMA), which is a scaled-up version of the size 4 and is generally recommended for patients over 90 kg, for positive pressure ventilation (PPV), ease of insertion, oropharyngeal and gastric insufflation pressures, fiberoptic positioning, and complication rates. ⋯ Positive pressure ventilation with the size 5 LMA is safe and effective with a low failure/problem rate using tidal volumes of 8 to 10 ml/kg, even in those patients who are moderately obese. The device is suitable for patients weighing under 90 kg in whom the seal with the size 4 is inadequate.
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Randomized Controlled Trial Comparative Study Clinical Trial
Laryngo-pharyngeal complaints following laryngeal mask airway and endotracheal intubation.
To investigate the incidence and severity of laryngo-pharyngeal complaints following anesthesia with the use of a laryngeal mask airway (LMA) compared with endotracheal intubation in adults. ⋯ There is a distinct pattern of laryngo-pharyngeal complaints following the use of the LMA and endotracheal intubation. With regard to minor laryngo-pharyngeal morbidity, the advantage of the LMA to endotracheal intubation is questionable.
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Comparative Study Clinical Trial
Comparative recovery of 50-Hz and 100-Hz posttetanic twitch following profound neuromuscular block.
To determine if posttetanic twitch following 100-Hz tetanic stimulation enables titration of a nondepolarizing relaxant infusion to a greater depth of block than that achieved with posttetanic twitch following 50 Hz. ⋯ Posttetanic twitch following 100-Hz tetanic stimulation enables titration of a vecuronium infusion to a greater depth of block than posttetanic twitch following 50-Hz tetanic stimulation. The present findings should enable more effective titration of this relaxant, thereby reducing the likelihood of unwanted patient movement or unduly prolonged recovery due to relaxant overdosing.