Journal of anesthesia
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Journal of anesthesia · Oct 2011
Randomized Controlled TrialIntraoperative reversal of neuromuscular block with sugammadex or neostigmine during extreme lateral interbody fusion, a novel technique for spine surgery.
Extreme lateral interbody fusion (XLIF) is a method for stabilization of the lumbar spine. Intraoperatively, the surgeon identifies the lumbar nerve roots with a stimulator to prevent their injury. The objective of this study was to determine the extent to which shallow rocuronium-induced neuromuscular block must be intraoperatively reversed for reliable identification of nerve roots. ⋯ Intraoperative reversal of shallow rocuronium-induced block with either sugammadex or neostigmine is an efficient method. For reliable detection of lumbar nerve roots with a stimulating current of 10 mA, the block should be reversed to a TOF ratio of at least 0.70. For a current intensity of 5 mA, the TOF ratio should reach 0.90.
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Journal of anesthesia · Oct 2011
Randomized Controlled TrialThe effect of patient-controlled intravenous analgesia on postoperative hypokalemia in patients undergoing laparoscopic cholecystectomy.
We investigated whether hypokalemia developed during the postoperative period and whether the use of intravenous patient-controlled analgesia (IV-PCA) could decrease the incidence of postoperative hypokalemia in patients who underwent laparoscopic cholecystectomy. ⋯ The results show that hypokalemia developed during the perioperative period and the use of IV-PCA in patients undergoing laparoscopic cholecystectomy effectively decreased the degree and incidence of postoperative hypokalemia on the day of the operation and postoperative day one.
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Journal of anesthesia · Oct 2011
Randomized Controlled TrialFlurbiprofen axetil enhances analgesic effect of fentanyl associated with increase in β-endorphin levels.
To examine the analgesic effect of preoperative administration of flurbiprofen axetil and that of postoperative administration of a combination of flurbiprofen axetil and fentanyl, as well as perioperative plasma β-endorphin (β-EP) levels in patients undergoing esophagectomy. ⋯ These results show that flurbiprofen axetil enhances the analgesic effect of fentanyl associated with increase in β-EP levels.
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Journal of anesthesia · Aug 2011
Randomized Controlled Trial Clinical TrialThe effect of oral clonidine premedication on blood loss and the quality of the surgical field during endoscopic sinus surgery: a placebo-controlled clinical trial.
Bleeding during functional endoscopic sinus surgery (FESS) remains a challenge for both surgeons and anesthesiologists despite several modalities available for improving the surgical field. This study was conducted to evaluate the effect of oral clonidine premedication on blood loss and the quality of the surgical field in FESS. In a placebo-controlled clinical trial, a total of 84 American Society of Anesthesiologists (ASA) physical status I-II patients undergoing endoscopic sinus surgery for chronic sinusitis were randomly allocated to receive either oral clonidine 0.2 mg or identical-looking placebo tablets 90 min before arrival at the operating room. ⋯ The median (range) bleeding score in the clonidine group was significantly lower than that in the placebo group (2 (1-3) vs. 2.5 (2-4), p < 0.0001). Accordingly, the surgeon was more satisfied with the surgical field in the clonidine group than with that in the placebo group (median score, 4 (3-5) vs. 3 (1-5), p < 0.001). In conclusion, premedication with oral clonidine 0.2 mg can effectively reduce bleeding during FESS.
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Journal of anesthesia · Jun 2011
Randomized Controlled TrialCharacteristics of unilateral spinal anesthesia at different speeds of intrathecal injection.
Unilateral spinal anesthesia is performed to provide restriction of sympathetic and motor block. The purpose of this study is to compare the effect of different speeds of intrathecal injection on unilateral spinal anesthesia. ⋯ The result of the study show that the extra-slow injection of hyperbaric bupivacaine provided strictly unilateral sensorial and sympathetic block in 93.9 and 87.9% of the patients, respectively, and that a slow injection of low doses of hyperbaric 0.5% bupivacaine 1 ml was sufficient to provide unilateral spinal anesthesia.