Journal of clinical anesthesia
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Randomized Controlled Trial Clinical Trial
Interpleural analgesia with bupivacaine following thoracotomy: ineffective results of a controlled study and pharmacokinetics.
To evaluate intrapleural analgesia with bupivacaine following partial pulmonary resection and to determine pharmacokinetic parameters of bupivacaine with epinephrine. ⋯ Intrapleural analgesia conducted with 40 ml of 0.25% bupivacaine with epinephrine or 20 ml of 0.5% bupivacaine with epinephrine was insufficient for pain, despite high plasma bupivacaine concentration.
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Randomized Controlled Trial Clinical Trial
Hemodynamic stability and patient satisfaction after anesthetic induction with thiopental sodium, ketamine, thiopental-fentanyl, and ketamine-fentanyl.
To examine three commonly used anesthetic induction regimens (thiopental sodium, ketamine, and thiopental plus fentanyl) and one newly described regimen (ketamine plus fentanyl) with respect to hemodynamic stability and patient satisfaction. ⋯ The combination of ketamine plus fentanyl provides superior hemodynamic stability with excellent patient satisfaction.
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Comparative Study
A comparison of desflurane and isoflurane in prolonged surgery.
To compare desflurane with isoflurane in several anesthetic situations. ⋯ Desflurane is similar to isoflurane in providing anesthesia for intubation and maintenance. Desflurane tends to increase HR and occasionally causes a hyperdynamic response during rapid deepening of anesthesia. It is very similar to isoflurane in its interaction with pancuronium.
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Review Case Reports
Adult epiglottitis and postobstructive pulmonary edema in a patient with severe coronary artery disease.
Epiglottitis is a rare cause of upper airway obstruction that may lead to death in the adult. We report the case of a patient with severe coronary artery disease with adult epiglottitis who required emergency endotracheal intubation. Relief of the airway obstruction was followed by the development of postobstructive pulmonary edema. ⋯ All others should be observed in an intensive care unit with a skilled anesthesiologist available to carry out emergency endotracheal intubation. Inhalation induction with halothane in oxygen should be considered initially; failing that, rigid bronchoscopy, tracheostomy, or transtracheal ventilation should be available. Postobstructive pulmonary edema should be anticipated after relief of airway obstruction has occurred; it can be treated with fluid restriction, diuretics, and continuous positive airway pressure.
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To delineate current practice with regard to how coagulation status is evaluated before induction of regional anesthesia in the preeclamptic parturient, with the goal of defining appropriate testing. ⋯ In the majority of academic programs in the United States, we found that the evaluation of coagulation status in the preeclamptic parturient was based primarily on a platelet count. A review of the literature supports this pattern of testing.