Journal of anesthesia
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Journal of anesthesia · Jun 2013
Randomized Controlled TrialA prospective, randomized, double-blind study to compare the efficacy of lidocaine + metoclopramide and lidocaine + ketamine combinations in preventing pain on propofol injection.
Propofol injection is known to cause distressing pain, and various methods have been used to decrease this pain. We investigated the efficacy of the lidocaine + metoclopramide and lidocaine + ketamine combinations on modulating propofol injection pain. ⋯ The lidocaine-ketamine combination is most effective for decreasing the pain on propofol injection.
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Journal of anesthesia · Jun 2013
ReviewResuscitation after hemorrhagic shock: the effect on the liver--a review of experimental data.
The liver is currently considered to be one of the first organs to be subjected to the hypoxic insult inflicted by hemorrhagic shock. The oxidative injury caused by resuscitation also targets the liver and can lead to malfunction and the eventual failure of this organ. Each of the various fluids, vasoactive drugs, and pharmacologic substances used for resuscitation has its own distinct effect(s) on the liver, and the anesthetic agents used during surgical resuscitation also have an impact on hepatocytes. ⋯ The effect of a specific resuscitation agent on the liver is assessed mainly by measuring apoptotic pathway regulators and inflammation-induced indicators. Apart from a wide range of pharmacological substances, modifications of Ringer's Lactate, colloids, and pyruvate provide protection to the liver after hemorrhage and resuscitation. In this setting, it is of paramount importance that the treating physician recognize those agents that may attenuate liver injury and avoid using those which inflict additional damage.
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Journal of anesthesia · Jun 2013
Analysis of prehospital endotracheal intubation performed by emergency physicians: retrospective survey of a single emergency medical center in Japan.
Advanced airway management in the prehospital setting is a serious issue in Japan because emergency medical technicians are not authorized to perform such management, whereas physicians-who are authorized to perform advanced airway management-do not usually engage in prehospital emergency medical activity. The purpose of this investigation was to investigate the success rate for endotracheal intubation (ETI) procedures and other methods of airway management employed by physicians in the prehospital setting in a single institution, as well as to examine the risk factors associated with difficult or failed endotracheal intubation (D/F ETI). ⋯ The success rate for ETI performed by physicians in the prehospital setting at a single emergency medical center was high, and the incidence of D/F ETI was 4.31 %. The success rate for ETI in the CPA group was greater than that in the non-CPA group.
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Journal of anesthesia · Jun 2013
Randomized Controlled TrialComparison of the use of the Valsalva maneuver and the eutectic mixture of local anesthetics (EMLA®) to relieve venipuncture pain: a randomized controlled trial.
Intravenous cannulation is a painful and stressful procedure. The objective of this study was to compare the analgesic efficacy of the eutectic mixture of local anesthetics (EMLA(®)) with that of the Valsalva maneuver in adult patients during i.v. cannulation. ⋯ The Valsalva maneuver yields similar results to the EMLA(®) in terms of pain reduction during venipuncture.