Journal of anesthesia
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Journal of anesthesia · Aug 2010
Randomized Controlled TrialDifferential effects of hyperventilation on cerebral blood flow velocity after tourniquet deflation during sevoflurane, isoflurane, or propofol anesthesia.
The purpose of this study was to compare the degree of increase in middle cerebral artery (MCA) blood flow velocity after tourniquet deflation when modulating hyperventilation during orthopedic surgery under sevoflurane, isoflurane, or propofol anesthesia. Twenty-four patients undergoing elective orthopedic surgery were randomly divided into sevoflurane, isoflurane, and propofol groups. Anesthesia was maintained with sevoflurane, isoflurane, or propofol administration with 33% oxygen and 67% nitrous oxide at anesthetic drug concentrations adequate to maintain bispectral values between 45 and 50. ⋯ In addition, during the study period, no difference in V (mca) after tourniquet deflation was observed between the propofol and sevoflurane groups. Hyperventilation could prevent an increase in V (mca) in the propofol and sevoflurane groups after tourniquet deflation. However, hyperventilation could not prevent an increase in V (mca) in the isoflurane group.
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Journal of anesthesia · Aug 2010
Randomized Controlled TrialEffects of landiolol on systemic and cerebral hemodynamics and recovery from anesthesia in patients undergoing craniotomy.
Maintenance of systemic and cerebral hemodynamics and quick recovery from anesthesia are required for craniotomy. We conducted a prospective randomized study to investigate the effects of continuous infusion of landiolol on hemodynamic responses to various stimuli, changes in systemic and cerebral hemodynamics during anesthesia, and recovery from anesthesia in patients undergoing craniotomy. ⋯ This study indicates that continuous infusion of landiolol suppressed hyperdynamic responses to stimuli during anesthesia while maintaining arterial blood pressure and cerebral oxygen balance during craniotomy. Although landiolol infusion did not affect recovery from anesthesia and incidence of PONV, it reduced intraoperative requirement of fentanyl.
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Journal of anesthesia · Aug 2010
Randomized Controlled Trial Comparative StudyEfficacy of epidural dexamethasone versus fentanyl on postoperative analgesia.
Dexamethasone has analgesic, anti-inflammatory, and antiemetic effects. This prospective, randomized, double-blind, controlled study was designed to evaluate the efficacy of adding dexamethasone versus fentanyl to epidural bupivacaine on postoperative analgesia. ⋯ This study revealed that epidural bupivacaine-dexamethasone admixture had almost the same analgesic potency as bupivacaine-fentanyl with opioid-sparing and antiemetic effects. Further studies are required to evaluate the optimum dose of epidural dexamethasone for postoperative analgesia.
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Journal of anesthesia · Aug 2010
Randomized Controlled TrialPretreatment with nafamostat mesilate, a kallikrein inhibitor, to decrease withdrawal response associated with rocuronium.
This randomized, double-blind, placebo-controlled study was conducted to examine the preventive effect of nafamostat mesilate, a kallikrein inhibitor, on the withdrawal response associated with rocuronium injection. ⋯ Pretreatment with 1.5 mg nafamostat mesilate decreased withdrawal response associated with rocuronium injection.
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Journal of anesthesia · Aug 2010
Randomized Controlled TrialThe effects of intravenous dexmedetomidine on spinal hyperbaric ropivacaine anesthesia.
In this study we investigated the effects of intravenously administered dexmedetomidine on the duration of hyperbaric ropivacaine in spinal anesthesia, and the side effects. ⋯ Our results show that intravenously administered dexmedetomidine prolonged the duration of spinal anesthesia, provided sufficient sedation, and had few side effects. Therefore, dexmedetomidine is appropriate during spinal anesthesia, if the anesthesiologist is alert for development of bradycardia.