Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Postoperative pain control with methadone following lower abdominal surgery.
To describe a technique for the use of methadone during and following lower abdominal surgery that integrates its pharmacokinetic and pharmacodynamic properties with the objective of postoperative analgesia; to compare methadone with morphine for postoperative pain control. ⋯ Sustained analgesia with methadone is predicted by its pharmacokinetics. Patients who received 22 +/- 2.9 mg of IV methadone (combined intraoperative and recovery room doses) reported less pain and required minimal additional analgesic over the next 72 hours than did patients who received morphine. This is consistent with sustained therapeutic plasma levels due to methadone's long plasma half-life (54 +/- 20 hours). Use of methadone in this manner is an effective therapy for postoperative pain control and is not associated with toxicity or notable side effects.
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Randomized Controlled Trial Clinical Trial
Continuous alfentanil infusion in pediatric patients undergoing general anesthesia for complete oral restoration.
To study the safety and efficacy of continuous alfentanil infusions in children. ⋯ Alfentanil appears to be a safe anesthetic. The reason for prolonged discharge time in the alfentanil-anesthetized patient is unclear, but it may be related to postoperative vomiting.
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To examine and compare the mechanism of injury, diagnostic findings, initial methods of airway management, and outcome of patients who had upper airway injuries. ⋯ In any patient with possible upper airway injury, plain radiographs of the chest and neck should be obtained to aid in the diagnosis. Elective intubation should be attempted only with a surgical team present and prepared for emergency tracheotomy. Fiber-optic bronchoscopy could be a valuable aid for both intubation and evaluation in such cases.
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To determine the level of care available to obstetric patients during the immediate postanesthesia period. ⋯ In many obstetric PACUs, the level of expertise of personnel needs to be upgraded to ensure the safety of patients recovering from general or major regional anesthesia and to comply with existing care standards.
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Clinical Trial
Accelerated recovery from doxacurium-induced neuromuscular blockade in patients receiving chronic anticonvulsant therapy.
To determine whether a drug interaction exists between doxacurium and anticonvulsants. ⋯ Chronic treatment with anticonvulsants results in more rapid recovery from neuromuscular blockade produced by doxacurium.