Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Spinal or systemic analgesia after extensive spinal surgery: comparison between intrathecal morphine and intravenous fentanyl plus clonidine.
To compare two different methods of postoperative analgesia after extensive spinal fusion. ⋯ This study shows that there is a major risk of respiratory depression with a single intrathecal dose of morphine 0.3 mg to control postoperative pain after scoliosis surgery. Systemic clonidine-fentanyl may be a possible approach to the postoperative pain treatment of this surgery.
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Randomized Controlled Trial Clinical Trial
Role of the laryngeal mask airway in the immobile cervical spine.
To determine whether the laryngeal mask airway has a useful role in the airway management of patients whose cervical spines are immobilized in a rigid cervical collar. ⋯ The laryngeal mask airway compared favorably with an endotracheal tube in success rate, difficulty of insertion, and time to position correctly in this patient population. Although the laryngeal mask does not reliably protect against aspiration, we believe it may play a useful role if more conventional methods of airway management fail. Further studies in the trauma scenario are indicated.
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We report an unusual case of endotracheal tube obstruction secondary to alteration of the preoperative fasting period. A patient scheduled for coronary artery bypass grafting had been instructed to take nothing by mouth except scheduled medication with sips of water prior to surgery. Induction of anesthesia and tracheal intubation were accomplished without incident. ⋯ We believe that the mass of gum caused enough deviation of the endotracheal tube to impair ventilation. The safety of preoperative gum chewing and liquid ingestion is discussed. Other incidents of anesthetic problems caused by modification of the traditional preoperative fast are highlighted.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of dexmedetomidine and midazolam sedation and antagonism of dexmedetomidine with atipamezole.
To evaluate the effects of dexmedetomidine, an alpha-2 agonist, as an intravenous sedative drug and the effects of atipamezole, an alpha-2 antagonist, on recovery. ⋯ Atipamezole is an effective antagonist for reversing psychomotor impairment following dexmedetomidine sedation.