Journal of anesthesia
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Journal of anesthesia · Jan 2009
Randomized Controlled TrialPostoperative analgesia with minidose intrathecal morphine for bipolar hip prosthesis in extremely elderly patients.
It is known that an optimal dose of intrathecal morphine for analgesia after total hip arthroplasty in older patients is 0.1 mg. On the other hand, minidose intrathecal morphine (0.05 mg) is useful for analgesia after the transurethral resection of the prostate in elderly patients. We evaluated the postoperative analgesic effect of minidose intrathecal morphine after bipolar hip prosthesis in seniors (age 85 years or more) undergoing spinal anesthesia. ⋯ The results show that minidose intrathecal morphine provides a good analgesic effect without side effects, and it would be an effective and safe procedure for bipolar hip prosthesis in seniors.
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Journal of anesthesia · Jan 2009
Randomized Controlled TrialPerineural morphine in patients with chronic ischemic lower extremity pain: efficacy and long-term results.
To compare the efficacy, safety, and impact on daily activity of peripherally administered morphine plus a local anesthetic with that of a local anesthetic alone in patients with chronic ischemic lower extremity pain. ⋯ A peripherally administered bupivacaine plus morphine combination provided better and longer analgesia for ischemic pain compared to bupivacaine alone for the short term, but not for the long term. On the other hand, our results show that continuous popliteal treatment is an effective, safe, and comfortable modality for long-term use in the home setting for patients with intractable chronic pain.
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Journal of anesthesia · Jan 2009
Case ReportsThe videolaryngoscope is less traumatic than the classic laryngoscope for a difficult airway in an obese patient.
This report describes the anesthetic management of an obese patient with a difficult airway and the merits of videolaryngoscopy, specifically in terms of the reduced risk of dental damage during intubation. A 49-year-old woman (body mass index; BMI, 36 kg.m(-2)), was scheduled to undergo an elective laparoscopic cholecystectomy because of cholelithiasis. ⋯ Intubation using a video-assisted Macintosh laryngoscope (V-Mac; Karl Storz, Tuttlingen, Germany) was successful upon the first attempt. The maximum force exerted on the patient's maxillary incisors was 61 N by direct laryngoscopy and 7.6 N using the indirect videolaryngoscope, both using a Macintosh blade.
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Journal of anesthesia · Jan 2009
Randomized Controlled TrialEffect of different anesthetic agents on oculocardiac reflex in pediatric strabismus surgery.
The oculocardiac reflex (OCR) occurs frequently during pediatric strabismus surgery. The aim of this study was to assess the effects of various anesthetic regimens on the incidence of OCR during the surgery. ⋯ Propofol or remifentanil anesthesia was associated with a higher incidence of OCR during pediatric strabismus surgery than sevoflurane and desflurane anesthesia, when either ketamine or midazolam was used as an induction agent.
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Journal of anesthesia · Jan 2009
Randomized Controlled TrialLow dose of fentanyl reduces predicted effect-site concentration of propofol for flexible laryngeal mask airway insertion.
In contrast to reports on the classical laryngeal mask airway (classical LMA; CLMA), no report has calculated the 50% and 95% effect-site concentrations (EC(50) and EC(95), respectively) of propofol required for flexible LMA (FLMA) insertion. This study was designed to determine the EC(50) and EC(95) of propofol for FLMA insertion, using probit analysis, and to investigate whether supplemental 0.25 microg x kg(-1) fentanyl decreased these concentrations. ⋯ The propofol EC(50) for FLMA insertion was decreased by supplemental 0.25 microg x kg(-1) fentanyl without BIS, hemodynamic, or respiratory depression.