Journal of anesthesia
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Journal of anesthesia · Jun 2012
Randomized Controlled TrialIV paracetamol effect on propofol-ketamine consumption in paediatric patients undergoing ESWL.
Electroshock wave lithotripsy (ESWL) is a painful procedure performed with sedoanalgesia in paediatric patients. The propofol-ketamine combination may be the preferable anaesthesia for this procedure, and propofol-ketamine consumption may be decreased with the administration of intravenous (IV) paracetamol. In this study we investigated the effect of IV paracetamol administration on propofol-ketamine consumption, recovery time and frequency of adverse events in paediatric patients undergoing ESWL. ⋯ Our data suggest that the administration of IV paracetamol decreases propofol-ketamine consumption for adequate sedation during ESWL procedures in paediatric patients and shortens recovery time.
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Journal of anesthesia · Jun 2012
Randomized Controlled Trial Comparative StudyAtomised intranasal midazolam spray as premedication in pediatric patients: comparison between two doses of 0.2 and 0.3 mg/kg.
Midazolam premedication administered by the intranasal route is noninvasive with good bioavailability. Atomised intranasal midazolam spray ensures accurate drug dosage and better patient acceptability, with rapid onset of action and virtually complete absorption. ⋯ Atomised midazolam at 0.3 mg/kg is safe, and achieves faster sedation and better separation scores as compared to 0.2 mg/kg.
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Journal of anesthesia · Jun 2012
Case ReportsSuccessful one-lung ventilation in a patient with the Fontan circulation undergoing thoracotomy: a case report.
The incidence of noncardiac surgery in patients with the Fontan circulation has increased over the years due to the elongated life expectancy of these patients. In patients with the Fontan circulation, pulmonary blood flow is passive, so it is important to keep pulmonary vascular resistance low. One-lung ventilation (OLV) can have adverse effects on the Fontan circulation due to hypoxia, hypoxic pulmonary vasoconstriction, hypercarbia, and increased airway pressure. We present a case of successful OLV in a patient with the Fontan circulation and describe our perioperative management.
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Journal of anesthesia · Jun 2012
Initial experience of the i-gel supraglottic airway by the residents in pediatric patients.
Insertion of a laryngeal mask airway (LMA) is occasionally difficult in children because of their anatomical features and variations. A new single-use supraglottic airway device, the i-gel airway, was recently introduced. The objective of this study was to show the initial experience of the i-gel airway device by the residents for pediatric patients. ⋯ These results show that the i-gel airway is a safe and effective device for use by residents who do not have experience with insertion of a pediatric LMA. However, using size 1.5, special caution should be taken to protect the infant airway, similar to what has been previously reported for other airway devices.
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Journal of anesthesia · Jun 2012
Effect of jaw thrust and cricoid pressure maneuvers on glottic visualization during GlideScope videolaryngoscopy.
During performance of direct laryngoscopy in the difficult-to-visualize airway, several maneuvers have the potential to impact glottic visualization, including jaw thrust and cricoid pressure. The effect of these maneuvers on glottic visualization during videolaryngoscopy has not been studied. We evaluated the effect of jaw thrust and cricoid pressure maneuvers on both visualization of the glottis and the area of glottic opening visible during GlideScope-aided videolaryngoscopy. ⋯ The jaw thrust maneuver was superior to videolaryngoscopy alone in improving the modified C&L grade and the visualized glottic area; however, no significant improvement was noted with cricoid pressure. We therefore recommend the use of jaw thrust as a first-line maneuver to aid in glottic visualization and tracheal intubation during GlideScope videolaryngoscopy.