Articles: general-anesthesia.
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Anesthesia and analgesia · Oct 2024
A Comparison of Remimazolam versus Propofol on Blood Pressure Changes During Therapeutic Endoscopic Retrograde Cholangiopancreatography: A Randomized Controlled Trial.
Intraoperative hypotension is the most common adverse event in endoscopic retrograde cholangiopancreatography (ERCP) and is usually attributed to the vasodilatory effect of the anesthetic. The aim of this randomized controlled trial was to evaluate the impact of remimazolam versus propofol on blood pressure changes during the therapeutic ERCP procedure. ⋯ Remimazolam may be considered as an alternative to propofol for general anesthesia during therapeutic ERCP procedures, with the potential advantage of stable hemodynamics.
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Anesthesia and analgesia · Oct 2024
Intraoperative Anesthesia-Related Critical Events in Low-Resource Hospitals During Short-Term Surgical Missions in Tanzania and Democratic Republic of the Congo: An Observational Study.
Critical incidents and mortality related to anesthesia are more frequently observed in low- and middle-income countries in comparison to high-income countries. The difficulties linked to anesthesia in rural areas of the Democratic Republic of the Congo (DRC) and Tanzania have limited documentation. The aim of this study was to comprehensively document anesthesia-related critical events that occurred during surgical missions organized by the nongovernmental organization 2nd Chance in hospitals in DRC and Tanzania. ⋯ The occurrence of critical events related to anesthesia appears to be high in this study. Due to numerous limitations, these results cannot be generalized to all hospitals in Tanzania and the DRC. However, this study underscores the challenges faced by anesthesia teams, encompassing inadequate resources, equipment deficiencies, and varying levels of expertise among anesthesia personnel. The research further stresses the significance of addressing these challenges to enhance patient safety.
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IV access is a commonly performed procedure that is often taught based on tradition rather than evidence. The effect of arm retroflexion on vein width, either alone or in combination with a tourniquet or general anesthesia (GA), remains unclear. In this case, the sonographically measured vein width is a surrogate parameter for the success of the puncture. ⋯ This study provides evidence that retroflexion of the arm in supine patients, whether alone or in addition to a tourniquet or general anesthesia, does not have any additional effect on vein width as a surrogate parameter for successful IV success. It shows for the first time that general anesthesia effectively increases vein diameter.
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Chronic insomnia disorder is a common sleep disorder. Previous studies have reported increased demand for anesthetics in patients with chronic insomnia disorder. However, few studies have investigated the effective dose of dexmedetomidine for sedation in patients with chronic insomnia disorder. We aimed to determine the 95% effective dose of dexmedetomidine to induce adequate sedation in patients with chronic insomnia disorder. ⋯ The 95% effective dose of dexmedetomidine to induce adequate sedation in patients with chronic insomnia disorder was 1.75 µg/kg.