Journal of clinical anesthesia
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Less than a decade ago, the only nondepolarizing neuromuscular blocking drugs available to the anesthetist were traditional long-acting drugs such as pancuronium and d-tubocurarine. The revolution that began 10 years ago in our use of relaxants promises to continue unabated into the next decade. Changes in our clinical use of these drugs will be sparked not just by the introduction of new drugs but also by a greater understanding of the pharmacokinetic/pharmacodynamic principles that govern onset and recovery.
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To determine the effect of reperfusion of the grafted liver on transcranial Doppler blood flow velocity in the middle cerebral artery in humans during orthotopic liver transplantation. ⋯ MCAVm increased with reperfusion of the grafted liver. These data suggest that multiple factors--including hypercarbia, lactic acidosis, or multiple vasoactive substances released by the grafted liver--may contribute to the observed increases in MCAVm, Vs, and PI.
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To examine the anesthetic gas leakage and prelaryngeal position of the laryngeal mask airway (LMA). ⋯ The LMA is a new airway management technique with good qualities of tightness and ventilation conditions. However, contraindications such as patients with a full stomach, intra-abdominal surgery, high peak airway pressure, prolonged operation, and an inexperienced anesthesiologist apply.
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Comparative Study
Thromboelastography and Sonoclot analysis in the healthy parturient.
To compare values for two whole blood viscoelastic coagulation tests, thromboelastography (TEG) and Sonoclot analysis (Sonoclot R Coagulation Analyzer, Sienco, Inc., Morrison, CO), between healthy parturients and nonparturients. ⋯ The differences found in the parturients reflect a hypercoagulable state. If these tests are to be used in evaluating obstetric patients, the results should be compared with values obtained for healthy parturients, not healthy nonparturients.