Journal of clinical anesthesia
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Randomized Controlled Trial Clinical Trial
Epidural mepivacaine for cesarean section: effects of a pH-adjusted solution.
To determine the clinical effects of the alkalinization of 2% mepivacaine with epinephrine used for epidural block during cesarean section. ⋯ The alkalinization allowed the surgery to proceed more rapidly, significantly decreasing the time interval between epidural block and delivery of the infant.
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The beginnings of organized emergency care can be traced through military history dating back to the Middle Ages. In 1769, the first civilian rescue society was established to look after shipwrecked persons. Sociological and technical requirements of the late 19th century led to the formation of different rescue associations and to writing of regulations for rescue and ambulance services. ⋯ Today the rescue service functions to bring a physician, often an anesthesiologist, to the victim as quickly as possible. Modern rescue laws fix a lead time of 5 to 15 minutes for a professional rescue service to reach the scene. The medical equipment and qualifications of personnel treating life-threatening trauma and diseases have improved, and in this context, the role of the anesthesiologist is important.
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In January 1986, West German legislators enacted the Medical Equipment Ordinance (MedGV) to define specific regulations for both manufacturers and operators of medical equipment and to offer a measure of safety to patients. We describe the history of MedGV, its regulations, and the mechanisms developed to enforce those regulations. ⋯ Finally, we focus our discussion on the distinction between improved equipment as a minor factor in critical-incidents and the inadequate manpower as a major factor in anesthesia mishaps. It is unclear what will develop after 1993, when the national states in Europe form a common market.
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Randomized Controlled Trial Comparative Study Clinical Trial
The effectiveness of oral clonidine as a sedative/anxiolytic and as a drug to blunt the hemodynamic responses to laryngoscopy.
To determine the effects of oral clonidine premedication on sedative, anxiolytic, and hemodynamic responses during the immediate preoperative period, laryngoscopy/intubation, and postanesthetic recovery. ⋯ Oral clonidine 0.2 mg was effective in reducing the level of behavioral and hemodynamic responses preoperatively and in blunting systolic hypertension produced by prolonged laryngoscopy.
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Randomized Controlled Trial Clinical Trial
Intubating conditions after pipecuronium bromide: the influence of dose and time.
To determine the intubating conditions following the administration of pipecuronium bromide in doses of two (0.07 mg/kg) or three (0.1 mg/kg) times ED95 (average dose that gives 95% block of the first twitch). ⋯ Pipecuronium has a relatively rapid onset. The trachea could be intubated successfully in 11/2 minutes with a dose of either 0.07 mg/kg or 0.1 mg/kg. If the clinical situation requires perfect relaxation with no movement or bucking, we recommend waiting at least 21/2 minutes.