Journal of anesthesia
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Journal of anesthesia · Feb 2013
Randomized Controlled TrialEpinephrine decreases the dose of hyperbaric bupivacaine necessary for tourniquet pain blockade during spinal anesthesia for total knee replacement arthroplasty.
We quantified the dose-sparing effect of epinephrine by comparing the median effective dose (ED(50)) of intrathecal hyperbaric bupivacaine co-administered with epinephrine with the ED(50) of intrathecal hyperbaric bupivacaine alone. ⋯ Intrathecal epinephrine did not decrease the dose of intrathecal hyperbaric bupivacaine required for successful anesthesia. However, it reduced the dose required for tourniquet pain blockade.
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Journal of anesthesia · Dec 2012
Randomized Controlled Trial Comparative StudyComparison of the effects of intranasal midazolam versus different doses of intranasal ketamine on reducing preoperative pediatric anxiety: a prospective randomized clinical trial.
To compare the effects of intranasal midazolam versus different doses of intranasal ketamine on reducing preoperative pediatric anxiety. ⋯ Intranasal midazolam was more effective than low- or high-dose intranasal ketamine in reducing preoperative pediatric anxiety. The lower dose of ketamine reduced preoperative anxiety more than a higher dose of ketamine, which may be clinically insignificant.
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Journal of anesthesia · Dec 2012
Randomized Controlled TrialThe effects of magnesium sulfate on neuromuscular blockade by cisatracurium during induction of anesthesia.
During the induction of anesthesia, patients are at risk of aspiration while awaiting full muscle relaxation. Magnesium has been shown to have synergistic effects with neuromuscular blocking drugs. We tested if magnesium, as an adjunct, increases the speed of onset of muscle relaxation, thereby decreasing the risk of aspiration. ⋯ The increased speed of onset of muscle relaxation produced by magnesium is not substantial enough to justify its use in combination with cisatracurium in rapid sequence induction.
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Journal of anesthesia · Dec 2012
Randomized Controlled TrialEffects of oral rehydration therapy on gastric volume and pH in patients with preanesthetic H2 antagonist.
Recent preanesthetic fasting practice allows patients to take clear fluids up to 2 h before surgery without taking any antacid for the prophylaxis of aspiration pneumonia; this practice is defined as oral rehydration therapy (ORT). It has been reported that with ORT the gastric volume may be significantly lower than that with a standard fasting regimen, although in a standard fasting regimen without preanesthetic antacid, gastric pH and volume values could be critical for causing aspiration pneumonia. In this study we compared gastric fluid status in patients with ORT and those with a standard fasting regimen; patients in both groups received a preanesthetic H(2) antagonist. ⋯ After the induction of anesthesia, the gastric contents were collected via a gastric tube to measure gastric volume and pH. Neither gastric volume nor pH differed between the groups (ORT 9.6 ± 8.2 ml and 5.6 ± 1.7, respectively, vs. standard fasting 8.5 ± 6.8 ml and 5.5 ± 1.7, respectively). These data suggest that ORT may not reduce gastric volume in patients receiving a preanesthetic H(2) antagonist.
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Journal of anesthesia · Dec 2012
Randomized Controlled TrialAdding pregabalin to a multimodal analgesic regimen does not reduce pain scores following cosmetic surgery: a randomized trial.
Multimodal analgesia increases the chance of successful discharge and pain control after surgery, and pregabalin is being promoted as an effective analgesic, based on placebo-controlled studies. We investigated whether adding pregabalin improved pain control and reduced opioid requests when it was added to a multimodal analgesic regimen for cosmetic surgery. ⋯ Perioperative pregabalin 75 mg twice a day does not increase benefit when it is added to an already multimodal analgesic regimen for patients undergoing cosmetic surgery. Several factors could explain our findings, including the possibility of publication bias in the current literature.