Journal of anesthesia
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Journal of anesthesia · Dec 2010
Randomized Controlled Trial Comparative StudyAnalysis of the cost-effectiveness of remifentanil-based general anesthesia: a survey of clinical economics under the Japanese health care system.
Remifentanil has been available in Japan for 3 years. The use of this new opioid is considered a useful adjuvant to general anesthesia. Knowing the exact cost-effectiveness of remifentanil should lead to improved anesthetic outcomes with a reasonable cost. ⋯ This study shows that remifentanil-based general anesthesia is no more expensive than conventional fentanyl-based anesthesia under the Japanese health care system because of the small difference in price between remifentanil and fentanyl.
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Journal of anesthesia · Dec 2010
Randomized Controlled TrialLocal warming at injection site helps alleviate pain after rocuronium administration.
Various strategies have been proposed to reduce discomfort of pain after rocuronium injection. These studies have shown pretreatment of drugs such as fentanyl and lidocaine to be effective. In a prospective randomized study, we evaluated whether pretreatment with local warming at injection site using an air-warming device could effectively alleviate pain induced by rocuronium. ⋯ Application of warmth over the vascular access prior to rocuronium administration effectively reduces injection-related pain.
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Journal of anesthesia · Dec 2010
Randomized Controlled TrialThe effect of injection speed on the spinal block characteristics of hyperbaric bupivacaine 0.5% in the elderly.
The purpose of this prospective, randomized, double-blind study was to compare anesthetic characteristics after two speeds of intrathecal injection of hyperbaric bupivacaine in elderly patients. ⋯ An eightfold difference in speed of intrathecal injection of 0.5% hyperbaric bupivacaine did not affect the clinical characteristics of spinal anesthesia in elderly patients undergoing transurethral surgery.
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Journal of anesthesia · Dec 2010
Randomized Controlled Trial Comparative StudyDexmedetomidine-ketamine and midazolam-ketamine combinations for sedation in pediatric patients undergoing extracorporeal shock wave lithotripsy: a randomized prospective study.
Extracorporeal shock wave lithotripsy (ESWL) requires sedation in pediatric patients. Dexmedetomidine is a relatively new agent used for sedation. The aim of this randomized prospective study was to compare the effects of dexmedetomidine-ketamine and midazolam-ketamine combinations on the recovery time, hemodynamic and respiratory variables, and side effects in pediatric patients undergoing ESWL. ⋯ In this study we found the recovery time to be shorter, with hemodynamic stability, in the dexmedetomidine group, compared with the midazolam group. So we can conclude that dexmedetomidine may be a good and safe alternative agent for sedation, with a shorter recovery period than midazolam, in the pediatric population.
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Journal of anesthesia · Dec 2010
Randomized Controlled Trial Comparative StudyComparisons of two different doses of fentanyl for procedural analgesia during epidural catheter placement: a double-blind prospective, randomized, placebo-controlled study.
The purpose of this study was to investigate the effect of fentanyl on analgesic properties and respiratory responses during an epidural procedure. Sixty patients premedicated with oral brotizolam 0.25 mg were allocated to receive procedural analgesia with saline or 25 or 50 μg of fentanyl. Five minutes after administration, an epidural procedure was started. ⋯ Seven of 20 cases in the 50 μg fentanyl group needed oxygen administration because of a decreased SpO₂ value (<94%). No cardiovascular complications were observed in any group during the entire study period. Thus, intravenous fentanyl at a dose of 25 μg provides effective procedural analgesia without the risk of hypoxemia during an epidural procedure in a patient with preanesthetic medication.