Articles: anesthesia.
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Journal of anesthesia · Feb 2025
Randomized Controlled TrialThe effect of intravenous lidocaine infusion on subarachnoid anesthesia in patients undergoing total knee replacement: a randomised controlled trial.
Intravenous lidocaine is a non-opioid analgesic adjunct for perioperative pain relief. The aim of our study was to explore whether concurrent administration of intravenous lidocaine prolongs the duration of sensory block during total knee replacement (TKR) under spinal anaesthesia. ⋯ During unilateral TKR under spinal anaesthesia, concurrent use of intravenous lidocaine prolonged sensory block and reduced postoperative analgesic requirements.
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Journal of anesthesia · Feb 2025
Randomized Controlled TrialStudy of penehyclidine for the prevention of postoperative nausea and vomiting following laparoscopic sleeve gastrectomy under general anesthesia: a randomized, prospective, double-blind trial.
To investigate the efficacy of penehyclidine (PHC) for preventing postoperative nausea and vomiting (PONV) after laparoscopic sleeve gastrectomy (LSG) under general anesthesia. ⋯ PHC effectively prevented PONV occurrence and reduced its severity in LSG patients without decreasing postoperative recovery outcomes, particularly in the infusion cohort.
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Randomized Controlled Trial Observational Study
Ultrasound-assisted middle thoracic epidural catheter placement utilizing the most dorsal sites of bilateral transverse process roots as anatomical landmarks: A cadaveric observational study and a clinical randomized controlled trial.
We developed an innovative method for ultrasound-assisted thoracic epidural catheter placement and assessed its potential to reduce procedural duration for trainees. ⋯ Our novel technique for thoracic epidural catheter placement resulted in expedited needling and enhanced success rates among trainees, although there was no significant difference between total procedure time when using ultrasound guidance and that when using conventional palpation.
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Randomized Controlled Trial Comparative Study
Sedoanalgesia with dexmedetomidine in daily anesthesia practices: a prospective randomized controlled trial.
Patient safety is important in daily anesthesia practices, and providing deep anesthesia is difficult. Current debates on the optimal anesthetic agents highlight the need for safer alternatives. This study was justified by the need for safer and more effective anesthetic protocols for outpatient hysteroscopic procedures, particularly those conducted outside the operating room. Propofol, while widely used, has significant limitations, including respiratory depression, hemodynamic instability, and delayed recovery when higher doses are required for adequate sedation. The addition of opioids to propofol, though beneficial for analgesia, introduces risks such as hypoxemia and hypotension. These challenges necessitate exploring alternative combinations that balance sedation depth with fewer side effects. ⋯ The dexmedetomidine-propofol combination is an effective and safe anesthetic regimen for deep sedation in outpatient hysteroscopic procedures, offering adequate sedation and superior preservation of respiratory function. Additionally, the dexmedetomidine-propofol combination ensures more stable hemodynamics, with a lower incidence of hypoxia, and results in higher satisfaction rates among patients, surgeons, and anesthesiologists.
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Randomized Controlled Trial
Effect of different doses of ciprofol on hemodynamics induced by general anesthesia in elderly diabetic patients undergoing spinal surgery: a double-blind, randomized, controlled study.
To evaluate the safety and efficacy of different doses of ciprofol for the induction of general anesthesia in elderly patients with diabetes undergoing spinal surgery. ⋯ The incidence of hypotension in Group C (46.4%) was significantly higher than that in Groups A (7.4%) and B (14.8%) (P < 0.05). The area under the time-mean arterial pressure curve (AUTMAP) was significantly greater in Group C (176.39 ± 33.83 mmHg·min) than in Group B (158.44 ± 26.55 mmHg·min) and Group A (143.59 ± 19.52 mmHg·min) (P < 0.05). The incidence of intubation response was highest in Group A (77.8%, P < 0.05). Significant differences in bispectral index (BIS) values were observed at 3, 4, and 5 min post-administration among the groups CONCLUSIONS: The induction regimen of 0.3 mg/kg ciprofol combined with 0.4 µg/kg sufentanil and 0.7 mg/kg rocuronium provided superior hemodynamic stability and reduced the need for vasoactive drugs in elderly diabetic patients. This regimen was found to be more favorable compared to the 0.2 mg/kg and 0.4 mg/kg ciprofol dosing groups, demonstrating an optimal balance of safety and efficacy during anesthesia induction in this high-risk population. This trial was registered in the Chinese Clinical Trial Registry on February 26, 2024 (Registration Number: ChiCTR2400081164).