Journal of clinical monitoring
-
Randomized Controlled Trial Clinical Trial
Effects of intravenous anesthetic agents on middle cerebral artery blood flow velocity during induction of general anesthesia.
Our objective was to quantify the effects of intravenous anesthetics on values measured by or derived from transcranial Doppler sonography (TCD) during induction of general anesthesia. ⋯ Under the circumstances of our study, values derived from TCD measurements responded differently to the agents used to induce general anesthesia in nonneurosurgical patients.
-
Randomized Controlled Trial Clinical Trial
EEG bispectrum predicts movement during thiopental/isoflurane anesthesia.
The objective of our study was to test the efficacy of the bispectral index (BIS) compared with spectral edge frequency (SEF), relative delta power, median frequency, and a combined univariate power spectral derivative in predicting movement to incision during isoflurane/oxygen anesthesia. ⋯ When bispectral analysis of the EEG was used to develop a retrospectively determined index, there was an association of the index with movement. Thus, it may be a useful predictor of whether patients will move in response to skin incision during anesthesia with isoflurane/oxygen.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Doppler-guided cannulation of the internal jugular vein: a prospective, randomized trial.
The internal jugular vein (IJ) is commonly used as an access to the central venous system. Despite the high success rate for cannulation of the IJ, the incidence of complications (1% to 16%) has remained essentially the same, with most complications resulting from unintentional punctures of surrounding structures. In an attempt to reduce the complication rate of this technique, we evaluated the use of a Doppler-guided needle device to cannulate the IJ. ⋯ The Doppler-guided cannulation technique can reduce the number of attempts required for successful IJ cannulation.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of intraarterial with continuous noninvasive blood pressure measurement in postoperative pediatric patients.
The purpose of this study was to estimate the accuracy, bias, and frequency response of continuous blood pressure monitoring using finger photoplethysmography in children. ⋯ Substantial measurement bias exits between this noninvasive blood pressure measurement technique and intraarterial blood pressure. Measurements of the intrapatient variability and frequency response analysis suggest that the noninvasive technique accurately tracks intraarterial blood pressure over the short term. This technique may have useful applications in settings where intraarterial monitoring is undersirable or unobtainable.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Radial artery cannulation: a comparison of 15.2- and 4.45-cm catheters.
Eighty-nine patients were studied prospectively to compare the incidence of postdecannulation arterial thrombosis and ischemic complications associated with percutaneous insertion of two different radial artery catheters. Patients scheduled for peripheral vascular surgery were randomized to receive a 15.2-cm (6 in, Argon Medical Corp.) or 4.45-cm (1.75 in, Arrow International, Inc.) 20-gauge, Teflon catheter. Extremity blood flow was evaluated prior to cannulation and again after decannulation with the modified Allen's test, pulse-volume plethysmography, and Doppler ultrasound. ⋯ Of the 8 patients with positive modified Allen's test who underwent radial artery cannulation, one suffered arterial occlusion. Radial artery cannulation with a 15.2-cm catheter was associated with a lower incidence of postdecannulation radial artery thrombosis than cannulation with the 4.45-cm catheter. Radial artery cannulation with longer catheters (greater than 5.0 cm) appears to be a safe practice.