Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Control of blood pressure and heart rate in patients randomized to epidural or general anesthesia for lower extremity vascular surgery. Perioperative Ischemia Randomized Anesthesia Trial (PIRAT) Study Group.
To examine the degree of success at maintaining patients randomized to epidural or general anesthesia for peripheral vascular surgery within predetermined blood pressure (BP) and heart rate (HR) limits. To investigate associations between such hemodynamic control and intraoperative myocardial ischemia and postoperative major cardiac morbidity. ⋯ Prevention of elevated intraoperative BP and/on rapid changes in BP or HR may be more successful with epidural than with general anesthesia. Such vital sign abnormalities may occur more frequently in patients who have had intraoperative ischemia or are at risk for having it later in the procedure.
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Randomized Controlled Trial Comparative Study Clinical Trial
Lidocaine plasma levels following two techniques of obturator nerve block.
To assess plasma levels and the potential toxicity of lidocaine following two different approaches to the obtruator nerve. ⋯ Despite a lower total dose of lidocaine administered (450 mg), higher mean and peak plasma levels were reached sooner with bilateral direct obturator nerve block compared with the indirect obturator nerve block (600 mg), indicating a faster blood absorption of lidocaine following direct block. Both types of obturator nerve block prevented adductor muscle contraction in a large percentage of cases.
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Historical Article
A curious moment: the proposal to certify nurse anesthetists by the American Board of Anesthesiology.
During the 1930s, many different practitioners gave anesthetics to patients. Qualifications were not necessary, and economics often drove the choice of anesthetic administrator. Both physicians and nurse specialists in anesthesia understood the need for specialty certification. ⋯ For one curious moment, the ABS asked the ABA to certify nurse anesthetists. Neither the nurses nor the physician anesthetists were overwhelmingly in favor of the proposal. However, had the proposal succeeded, the face of American anesthesiology would have been quite different.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
A phase III, multicenter, open-label, randomized, comparative study evaluating the effect of sevoflurane versus isoflurane on the maintenance of anesthesia in adult ASA class I, II, and III inpatients.
To compare the clinical efficacy and safety of sevoflurane and isoflurane when used for the maintenance of anesthesia in adult ASA I, II, and III inpatients undergoing surgical procedures of at least 1 hour's duration. ⋯ Sevoflurane anesthesia, as compared with isoflurane, may be advantageous in providing a smoother clinical course with a more rapid recover.
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Randomized Controlled Trial Comparative Study Clinical Trial
Prospective, randomized, double-blind, placebo-controlled comparison of metoclopramide and ondansetron for prevention of posttonsillectomy or adenotonsillectomy emesis.
To compare the antimetic efficacy of prophylactic ondansetron, metoclopramide, and placebo for prevention of postoperative vomiting in pediatric tonsillectomy or adenotonsillectomy patients. ⋯ Prophylactic ondansetron is more effective than metoclopramide or placebo for the prevention of vomiting after tonsillectomy or adenotonsillectomy. Patients who do not vomit postoperatively have shorter LOS.