Journal of clinical anesthesia
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Case Reports
General anesthesia for cesarean section in a parturient with a single ventricle and pulmonary atresia.
The successful management of a cesarean section in a parturient with a single ventricle and pulmonary atresia using general anesthesia is discussed. After cyanosis at birth, the patient underwent cardiac catheterization, which showed an apparent severe tetralogy of Fallot, atresia of the main pulmonary artery (PA), and a large patent ductus arteriosus. When she was 7 months of age, a Blalock-Taussig shunt (right subclavian artery to right PA) was done. ⋯ The patient was then taken to the operating room electively, and an opioid-based general anesthetic was administered. Both mother and infant did well. This case is presented because the physiology of the patient's lesion and her unusual social history presented challenges for her anesthetic management.
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Randomized Controlled Trial Clinical Trial
Prostaglandin E1 as a hypotensive drug during general anesthesia for total hip replacement.
To determine the effect of intravenous administration of prostaglandin E1 (PGE1) in inducing controlled hypotension during general anesthesia. ⋯ These data suggest that PGE1 can be used safely to induce hypotension, thereby reducing blood loss during total hip replacement with general anesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Which induction drug for cesarean section? A comparison of thiopental sodium, propofol, and midazolam.
To determine maternal and neonatal effects of three different induction drugs (thiopental sodium, propofol, and midazolam) for cesarean section. ⋯ Thiopental still remains the first-choice induction drug for cesarean section. The slow induction time with midazolam may put the mother at risk for pulmonary inhalation. A plane of anesthesia that may risk awareness and potential neonatal depression is the main drawback of the two newer induction drugs.
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Randomized Controlled Trial Clinical Trial
Using the laryngeal indices caliper to predict difficulty of laryngoscopy with a Macintosh #3 laryngoscope.
(1) To evaluate a device of the authors' design, the laryngeal indices caliper, which quantitates the position of the anterior edges of the larynx relative to the upper teeth and the external auditory canals; (2) to determine how relative laryngeal position affects ease of direct laryngoscopy with a Macintosh #3 laryngoscope. ⋯ (1) Laryngeal tilt is a good predictor of difficulty of laryngoscopy with a Macintosh #3 laryngoscope; (2) the laryngeal indices caliper is a simple pocket device to measure LT indirectly.
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Randomized Controlled Trial Comparative Study Clinical Trial
Propofol versus midazolam for monitored sedation: a comparison of intraoperative and recovery parameters.
To compare intraoperative and recovery parameters in patients who received either propofol infusion (PI), propofol bolus (PB), or midazolam bolus (MZ) for sedation. ⋯ The PI, PB, and MZ groups all gave excellent sedation for patients undergoing surgical procedures with local anesthesia. Amnesia was greatest with midazolam, and recovery was more rapid with propofol.