Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2007
Review Meta AnalysisDesflurane and sevoflurane in cardiac surgery: a meta-analysis of randomized clinical trials.
The authors performed a meta-analysis to investigate whether the cardioprotective effects of volatile anesthetics translate into decreased morbidity and mortality in patients undergoing cardiac surgery. ⋯ Desflurane and sevoflurane have cardioprotective effects that result in decreased morbidity and mortality. The present data show for the first time that the choice of an anesthetic regimen based on administration of halogenated anesthetics is associated with a better outcome after cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Aug 2007
Randomized Controlled Trial Comparative StudyCorrect depth of insertion of right internal jugular central venous catheters based on external landmarks: avoiding the right atrium.
Radiographically, a central venous catheter (CVC) tip should lie at the level of the right tracheobronchial angle. Precalculation of length of CVC insertion may avoid unnecessary catheter malposition. The purpose of this study was to assess the accuracy of a method of CVC positioning, based on external topographic landmarks. ⋯ It is recommended to use the topographic approach in deciding CVC depth with right internal jugular CVC placement.
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J. Cardiothorac. Vasc. Anesth. · Aug 2007
Randomized Controlled Trial Comparative StudyParasternal intercostal block with ropivacaine for pain management after cardiac surgery: a double-blind, randomized, controlled trial.
The purpose of this study was to test the hypothesis that administration of a parasternal intercostal block using ropivacaine 0.75% improved analgesia in postoperative cardiac surgical patients. ⋯ A ropivacaine parasternal intercostal block is a safe, simple, and effective adjunct for optimizing of pain control and reducing opioid analgesics after adult cardiac surgery. This study provides clinicians with an effective treatment for sternal wound pain.
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J. Cardiothorac. Vasc. Anesth. · Aug 2007
Comparative StudyTransmitral flow propagation velocity and assessment of diastolic function during abdominal aortic aneurysm repair.
In the perioperative arena, pronounced changes in cardiac loading conditions can make assessment of diastolic parameters difficult. A number of Doppler techniques have been introduced to assess perioperative diastolic function. ⋯ Vp assessment identified the majority (93%) of cases of diastolic dysfunction identified by traditional methods. Furthermore, the incidence of diastolic dysfunction increased with application of the AXC but returned to baseline after removal.