British journal of anaesthesia
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We present a 15-patient series of awake 'off-pump' [without cardiopulmonary bypass (CPB)] coronary artery bypass graft surgery, facilitated by thoracic epidural analgesia (TEA) and femoral nerve block. ⋯ Combined TEA and femoral block is a novel anaesthetic technique, and is feasible, for cardiac surgery. However, certain technical limitations need to be overcome to evaluate the full potential of 'awake' cardiac surgery.
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Randomized Controlled Trial
Tracheal intubation of morbidly obese patients: a randomized trial comparing performance of Macintosh and Airtraq laryngoscopes.
The Airtraq laryngoscope is designed to allow visualization of the glottis without alignment of the oral, pharyngeal, and laryngeal axes. We hypothesized that this new airway device would facilitate tracheal intubation of morbidly obese patients. We compared tracheal intubation performance of standard Macintosh laryngoscope with the Airtraq laryngoscope in morbidly obese patients. ⋯ In this study, the Airtraq laryngoscope shortened the duration of tracheal intubation and prevented reductions in arterial oxygen saturation in morbidly obese patients.
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Randomized Controlled Trial Comparative Study
Pathways through the nose for nasal intubation: a comparison of three endotracheal tubes.
In nasotracheal intubation, there are two main pathways in the nostril through which the endotracheal tube may pass. The lower pathway lies along the floor of the nose underneath the inferior turbinate. The upper pathway lies above the inferior turbinate, just below the middle turbinate. The lower pathway may be considered to be the safer route as it is located away from the middle turbinate and cribiform plate. ⋯ Endotracheal tubes, particularly preformed tubes, frequently take the less favourable pathway during nasotracheal intubation, in spite of specific attempts to avoid this.
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Randomized Controlled Trial
Postoperative beneficial effects of esmolol in treated hypertensive patients undergoing laparoscopic cholecystectomy.
In an attempt to decrease haemodynamic instability and early postoperative complications such as nausea, vomiting, and pain, esmolol was added to the routine alfentanil infusion of patients with treated hypertension undergoing laparoscopic cholecystectomy. ⋯ Esmolol had an opioid-sparing effect in the intraoperative and immediate postoperative period in hypertensive patients undergoing laparoscopy. When combined with alfentanil, it was more effective than placebo in decreasing early PONV.
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Randomized Controlled Trial
Comparative effects of propofol vs dexmedetomidine on cerebrovascular carbon dioxide reactivity in patients with septic shock.
The use of sedative drugs is reportedly related to altered cerebrovascular CO2 reactivity. The present study examined the comparative effects of propofol vs dexmedetomidine on cerebrovascular CO2 reactivity in patients with septic shock. ⋯ This study showed that cerebrovascular CO2 reactivity was lower under dexmedetomidine sedation than under propofol sedation during almost identical sedation in patients with septic shock.