Journal of anesthesia
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Journal of anesthesia · Jan 2006
Randomized Controlled TrialBispectral index-guided desflurane and propofol anesthesia in ambulatory arthroscopy: comparison of recovery and discharge profiles.
In this prospective, randomized study we compared the recovery profiles of bispectral index (BIS)-guided anesthesia regimens with desflurane or propofol in ambulatory arthroscopy. Fifty ASA I-II adult patients who underwent knee arthroscopy were randomized to receive desflurane (D) or propofol (P) infusion accompanied by remifentanil and nitrous oxide during maintenance, titrated to maintain a bispectral index value between 50 and 60. Initial awakening, fast-track eligibility, and home readiness as well as intraoperative hemodynamics, were compared. ⋯ However, home readiness did not differ significantly between the groups. Desflurane is an alternative to propofol for BIS-guided ambulatory anesthesia. Using desflurane in combination with opioid analgesics blunted its rapid emergence characteristics, and the higher frequency of emetic symptoms with desflurane diminished the success of its fast-track eligibility.
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Journal of anesthesia · Jan 2006
Randomized Controlled TrialDexmedetomidine during local anesthesia.
The objective of our study was to assess the efficacy and safety of dexmedetomidine given in a small dose for a 1-h infusion as an adjuvant to local analgesia in ophthalmic operations. The study was double-blind prospective, randomized, and placebo controlled. We studied the effects of a small dose of dexmedetomidine (0.5 micro.kg(-1).h(-1) for 10 min followed by 0.2 micro.kg(-1).h(-1) for 50 min. ⋯ Bispectral index values were significantly lower in the dexmedetomidine group than the placebo group. Also, intraocular pressure significantly decreased in the dexmedetomidine group compared to the placebo group. The study revealed that dexmedetomidine in the studied dose has a sedative effect, provides safe control of heart rate and blood pressure, and also decreases intraocular pressure during ophthalmic surgery under local anesthesia.
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Journal of anesthesia · Jan 2006
Randomized Controlled Trial Comparative StudyComparison between neurotropin and mepivacaine for stellate ganglion injection.
Neurotropin, a nonproteinaceous extract from the inflamed skin of rabbits inoculated with vaccinia virus, is reported to decrease pain effectively when used for stellate ganglion (SG) injection. We compared the effects of neurotropin SG injection with those of mepivacaine on pain relief, as well as comparing the side effects. One hundred and eighty-eight SG injections in 15 patients (5 with postherpetic neuralgia and 10 with sudden deafness) were performed either with 1% mepivacaine 6 ml or with neurotropin 3 ml combined with saline 3 ml in turn. ⋯ Blood pressure and heart rate did not change. In conclusion, the SG injection of neurotropin decreased the VAS score in postherpetic neuralgia to the same extent as mepivacaine. The incidence of Horner's sign was significantly lower with neurotropin than with mepivacaine.
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Journal of anesthesia · Jan 2006
Randomized Controlled TrialSite of fresh gas inlet and ratios of the delivered fraction and inspired fraction of inhaled isoflurane and sevoflurane in low-flow anesthesia.
The use of low-flow anesthesia causes a discrepancy between the delivered fraction (FD) and the inspired fraction (FI) of inhaled gases. We compared the FI/FD ratios of a new circle (fresh gas inlet located between the inspiratory valve and the patient) to those of the conventional circle (fresh gas inlet located between the inspiratory valve and the CO2 absorber) in low-flow isoflurane and sevoflurane anesthesia, using three anesthetic machines (Dräger NM-GS, Dräger Fabius-GS, and ACOMA KMA-1300-III). ⋯ The positioning of the fresh gas inlet between the inspiratory valve and the patient improved the FI/FD ratios of both isoflurane and sevoflurane during low-flow anesthesia in two decoupling-style anesthetic machines (ACOMA and Fabius).
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Journal of anesthesia · Jan 2006
Randomized Controlled TrialFlexible, tapered-tip tube facilitates conventional orotracheal intubation by novice intubators.
Orotracheal intubation is the standard technique for airway management, but several untoward airway complications are possible with this method. To avoid airway trauma caused by the tube tip during intubation, the Parker Flex-Tip tube (PFT), which has a flexible, tapered tip, was developed. It has been reported that the PFT facilitates fiberoptic orotracheal intubation and introducer-guided tracheal intubation. ⋯ PFT did not shorten the time required for intubation and did not reduce the incidence of sore throat and hoarseness. However, a detailed analysis revealed that the PFT decreased the time required for intubation in the anesthesia trainee group. The PFT may help novice intubators to conduct a smooth intubation.