Journal of anesthesia
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Journal of anesthesia · Dec 2011
Randomized Controlled TrialEffect of intravenous dezocine on fentanyl-induced cough during general anesthesia induction: a double-blinded, prospective, randomized, controlled trial.
To evaluate the suppressive effect of intravenous dezocine on fentanyl-induced cough during the induction of general anesthesia. ⋯ These results demonstrate that intravenous dezocine 0.1 mg/kg 10 min prior to induction was effective in suppressing fentanyl-induced cough in our patients.
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Journal of anesthesia · Dec 2011
Randomized Controlled TrialRetrospective analysis of spontaneous recovery from neuromuscular blockade produced by empirical use of rocuronium.
A train-of-four ratio (TOF ratio) of >0.9 should be the clinical cut-off to avoid residual paralysis. However, it is not rare to extubate patients without measurement of the TOF ratio, although the safe interval from the last administration of rocuronium assuring a TOF ratio of >0.9 has not been established in the daily clinical setting. In this study, to estimate the safe interval to avoid residual paralysis, we retrospectively selected patients in whom the TOF ratio was measured during remifentanil administration before extubation, and we studied the characteristics of recovery from the neuromuscular blockade produced by the empirical use of rocuronium. ⋯ Because of the large variation in the recovery from rocuronium-induced paralysis, TOF-based evaluation of residual paralysis is essential to determine the appropriate indication for reversal, especially for elderly patients.
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Journal of anesthesia · Dec 2011
Randomized Controlled TrialEffect of tranexamic acid on blood loss in pediatric cardiac surgery: a randomized trial.
The benefit of tranexamic acid (TXA) in pediatric cardiac surgery on postoperative bleeding has varied among studies. It is also unclear whether the effects of TXA differ between cyanotic patients and acyanotic patients. The aim of this study was to test the benefit of TXA in pediatric cardiac surgery in a well-balanced study population of cyanotic and acyanotic patients. ⋯ TXA can reduce blood loss in pediatric cardiac surgery but not the transfusion requirement (http://ClinicalTrials.gov number NCT00994994).
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Journal of anesthesia · Dec 2011
Randomized Controlled TrialDexmedetomidine can stabilize hemodynamics and spare anesthetics before cardiopulmonary bypass.
We previously confirmed the effectiveness of dexmedetomidine (DEX) for stabilizing hemodynamics as well as sparing anesthetics during anesthetic induction in patients undergoing cardiac surgery (Kunisawa et al. in J Clin Anesth 21:194-199, 1). In this study, we investigated whether these effects of DEX continue until the start of cardiopulmonary bypass (CPB). ⋯ DEX combined with 2 ng/ml fentanyl before CPB can suppress the decrease in blood pressure at the pre- and post-SI periods, can blunt the cardiovascular responses to SI and St, and can spare the required ESC of propofol despite fentanyl concentration, which was half of that in the placebo group.
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Journal of anesthesia · Dec 2011
Clinical TrialTissue Doppler imaging is useful for predicting the need for inotropic support after cardiac surgery.
Low preoperative left ventricular ejection fraction (EF) is a predictor of the need for inotropic support after cardiac surgery. However, EF can be misinterpreted and difficult to measure in some cases. The purpose of this study was to compare the value of preoperative EF and intraoperative tissue Doppler imaging variables in predicting the need for postoperative inotropic support. ⋯ This study suggests that those patients who have decreased S(m) and extended CPB times are more likely to require inotropic support after surgery, independent of a preserved left ventricular EF.