Journal of anesthesia
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Journal of anesthesia · Jan 2009
Randomized Controlled Trial Comparative StudyIsoflurane and sevoflurane decrease entropy indices more than halothane at equal MAC values.
Recently, bispectral index (BIS) values were demonstrated to be different for various anesthetics as a result of differential effects on electroencephalographic (EEG) signals. Entropy is similar to the BIS monitor, as both process raw EEG to derive a number. We hypothesized that entropy may also be anesthetic agent-specific. ⋯ During the study period, for a given MAC value, both RE and SE remained low in the isoflurane and sevoflurane groups compared to the halothane group. For a given MAC, the RE and SE were comparable during wash-in and wash-out phases. Halothane produced higher entropy values as compared to isoflurane and sevoflurane at equivalent MAC levels.
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There is growing evidence that early detection and response to physiological deterioration can improve outcomes for hospitalized infants, children, and adults. A rapid response system (RRS) is a multidisciplinary system to decrease the incidence of in-hospital cardiopulmonary arrests by detecting a crisis event and triggering a response and by dispatching a responding team. ⋯ The system is designed to locate and respond rapidly to a suddenly critically ill patient who lacks necessary critical care resources. Over the past decade, RRSs have been widely implemented in adult practice in the United States, Canada, Australia, the United Kingdom, and Scandinavian countries.
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Journal of anesthesia · Jan 2009
Randomized Controlled Trial Comparative StudyHyperventilation versus standard ventilation for infants in postoperative care for congenital heart defects with pulmonary hypertension.
In infants undergoing surgery for cardiac defects with left-to-right shunt, a hyperventilation strategy has been applied to prevent pulmonary hypertensive crisis (PHC). Hyperventilation with a large tidal volume and/or higher airway pressure, however, may be detrimental to the lung. This randomized study compared the effects of hyperventilation versus standard ventilation. ⋯ Hyperventilation may cause lung injury and systemic inflammation in infants with pulmonary hypertension undergoing corrective heart surgery.
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Journal of anesthesia · Jan 2009
Randomized Controlled TrialA randomized study of the effects of perioperative i.v. lidocaine on hemodynamic and hormonal responses for cesarean section.
Intravenous infusion of lidocaine attenuates the stress response to surgery. We aimed to evaluate the effects of perioperative lidocaine on the hemodynamic and hormonal responses for cesarean delivery. ⋯ Perioperative lidocaine is safe and effective in attenuating the maternal stress response to surgery for cesarean delivery.
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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.