Masui. The Japanese journal of anesthesiology
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To prevent catheter-related bloodstream infections (CRBSI), the use of maximal sterile barrier precautions (MSBP) during central venous catheter insertion, using a cap, mask, sterile gown, sterile gloves, and a large sterile sheet, was recommended in the Centers for Disease Control and Prevention Guidelines. However, this recommendation is based on the evidence obtained by only one randomized controlled trial (RCT) in which the subject patients were outpatients for chemotherapy. Nevertheless, the recommendation is applied to any kind of clinical settings. ⋯ There were 5 out of 211 cases (2.4%) of CRBSI in the MSBP group and 6 out of 213 cases (2.8%) in the SSBP group (P = 0.77). These results suggest that further RCTs should be necessary in many clinical settings to reach a conclusion on this issue. We also address other evidences regarding prevention of CRBSI in this review.
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Randomized Controlled Trial
[Preoperative intravenous administration of droperidol (1.25 mg) reduced postoperative nausea and vomiting after intrathecal morphine administration].
Intrathecal morphine (ITM) is an excellent postoperative analgesic, but may often cause postoperative nausea and vomiting (PONV). We designed this prospective, randomized and controlled study to evaluate the antiemetic efficacy of low-dose droperidol for the treatment of PONV caused by ITM. ⋯ Single intravenous administration of 1.25 mg droperidol before operation showed prophylactic efficacy in early PONV caused by ITM. The duration of droperidol action was shorter than that of ITM. Hence we recommend that droperidol should be administered more frequently or continuously in the postoperative period.
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Randomized Controlled Trial
[Optimal analgesic effect of continuous supraclavicular brachial plexus block with ropivacaine after shoulder surgery].
Optimal dose of local anesthetics for supraclavicular brachial plexus block (BPB) is still unknown. We prospectively investigated the analgesic effect of ultrasound-guided continuous supraclavicular BPB with ropivacaine at different infusion rates. ⋯ Continuous supraclavicular BPB with 0.2% ropivacaine at 6 ml x hr(-1) is effective for the pain management after shoulder surgery and is not an excess dose.
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Randomized Controlled Trial Comparative Study
[Remifentanil provides fast recovery and hemodynamic stability in laryngomicrosurgery anesthesia].
Stressful procedures such as intratracheal intubation and direct laryngoscopy in very short operations make anesthetic management for laryngomicrosurgery difficult. This study was conducted to evaluate which anesthetic agent, remifentanil or fentanyl, is suitable in anesthesia for laryngomicrosurgery. ⋯ Remifentanil provided faster recovery and hemodynamic stability. Therefore, remifentanil seems to be more suitable than fentanyl in anesthesia for laryngomicrosurgery.
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Randomized Controlled Trial
[Internal jugular vein cannulation guided by pulsation].
We are accustomed to right internal jugular vein (IJV) cannulation guided by pulsation for 20 years or more. This study was conducted to evaluate whether this method is a safe and certain method. ⋯ Internal jugular vein cannulation by pulsation method is a safe and certain method.