Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Serum and urine inorganic fluoride levels following prolonged low-dose sevoflurane anesthesia combined with epidural block.
To determine whether serum and urine inorganic fluoride levels with prolonged (more than 7 hours) low-dose (0.8 to 2.0 vol %) sevoflurane anesthesia plus epidural anesthesia were increased as compared with isoflurane anesthesia plus epidural anesthesia. To measure the urine tubular enzymes N-acetyl-beta-glucosaminidase (NAG), alpha 1-microglobulin (alpha 1-M), and beta 2-microglobulin (beta 2-M) for renal tubular injury in both groups. ⋯ There was no increase in urinary enzymes, which are indicators of tubular injury, specific to sevoflurane. There was no postoperative renal dysfunction, as indicated by unchanged serum creatinine and blood urea nitrogen levels.
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Randomized Controlled Trial Comparative Study Clinical Trial
Continuous administration of fentanyl for postoperative pain: a comparison of the epidural, intravenous, and transdermal routes.
To evaluate the influence of the route of administration [epidural, intravenous (IV), or transdermal] on onset and quality of analgesia and to evaluate the pharmacokinetics of continuous administration of fentanyl. ⋯ The epidural, transdermal, and IV administration of identical doses of fentanyl given at a constant rate provided almost equivalent degrees of analgesia. But continuing epidural administration produced a steady rise in systemic fentanyl concentrations into the ventilatory-depressant range, affecting the hypoxemic regulation of breathing.
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Randomized Controlled Trial Comparative Study Clinical Trial
Bair hugger forced-air warming maintains normothermia more effectively than thermo-lite insulation.
To compare the ability of forced-air warming and reflective insulation to maintain intraoperative normothermia. ⋯ Reflective insulation was unable to maintain intraoperative normothermia during total hip arthroplasty. Active warming, such as that provided by forced air, was required to prevent hypothermia.
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Randomized Controlled Trial Clinical Trial
Clinical pharmacology of rocuronium (Org 9426): study of the time course of action, dose requirement, reversibility, and pharmacokinetics.
To evaluate the time course of action, dose requirement, reversibility, and pharmacokinetics of rocuronium (Org 9426) under 3 anesthetic techniques (nitrous oxide-fentanyl supplemented with propofol, halothane, or isoflurane). ⋯ Isoflurane potentiates the rocuronium-induced neuromuscular block, resulting in a longer clinical duration and lower maintenance dose requirement. This difference is not explained by differences in pharmacokinetics but is probably due to increased sensitivity of the neuromuscular junction to rocuronium during isoflurane anesthesia.
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Randomized Controlled Trial Clinical Trial
Dexmedetomidine premedication before intravenous regional anesthesia in minor outpatient hand surgery.
To assess the efficacy and safety of intravenous (i.v.) dexmedetomidine, an alpha-2 agonist, as a premedication before i.v. regional anesthesia. ⋯ Dexmedetomidine is an effective premedication before i.v. regional anesthesia because it reduces patient anxiety, sympathoadrenal responses, and opioid analgesic requirements.