Articles: anesthetics.
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Anesthesia and analgesia · Mar 2008
Multicenter Study Comparative Study Clinical TrialA simplified approach to vertical infraclavicular brachial plexus blockade using hand-held Doppler.
In this observational study, we used Doppler ultrasound during the performance of vertical infraclavicular brachial plexus blockade. The success rate at inserting the needle at the point where the sound of the subclavian artery via Doppler reached its maximum audibility was compared with that of the classical insertion point. In 89 of the 100 patients, the medial or posterior cord was found at first needle pass. Using the Doppler point for insertion resulted in a significantly more lateral entry point compared with the classical point (P < 0.001) and was associated with a high success rate of infraclavicular block.
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Acta Anaesthesiol Belg · Jan 2008
Randomized Controlled Trial Multicenter StudyDoes the use of a volatile anesthetic regimen attenuate the incidence of cardiac events after vascular surgery?
To compare the effects of a volatile anesthetic to a non-volatile anesthetic regimen on the incidence of postoperative cardiac events, including the postoperative elevation of troponin I values after arterial vascular surgery in high risk patients. ⋯ The results of this hypothesis-generating study suggest that potential beneficial effects on extent of postoperative myocardial damage in high risk patients undergoing arterial surgery will probably be more apparent in abdominal aortic surgery than in peripheral vascular surgery. Further sufficiently powered studies using a standardized protocol should now be performed to definitively address this question.
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Anesthesia and analgesia · Jan 2008
Randomized Controlled Trial Multicenter StudyDisposition and clinical outcome after intraperitoneal meperidine and ropivacaine administration during laparoscopic surgery.
Limited evidence supports the efficacy of intraperitoneal (IP) meperidine or local anesthetic for postoperative analgesia. Our study aims were to investigate analgesic efficacy and to quantify the plasma concentrations of meperidine and ropivacaine after IP administration. The null hypothesis was that there was no significant difference among groups for dynamic pain in the first 24 h after major abdominal laparoscopic surgery. ⋯ Compared with systemic opioid, IP meperidine and ropivacaine, alone or in combination, did not produce better pain relief or opioid dose-sparing after laparoscopic surgery.
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Anesthesia and analgesia · Jan 2008
Randomized Controlled Trial Multicenter Study Clinical TrialDoes spectral entropy reflect the response to intubation or incision during propofol-remifentanil anesthesia?
Spectral entropy is an electroencephalogram-based monitoring technique with a frequency band enlarged to include the electromyogram spectrum, which is intended to help to assess analgesia. Although its correlation with hypnosis has been shown, its performance during a noxious stimulation and the influence of neuromuscular blockade have not been described. ⋯ Entropy predicted a motor response to noxious stimulations but not a hemodynamic response, which limits its usefulness for assessing the analgesic component of anesthesia in paralyzed patients. High values (RE >55) before the stimulation should be avoided in order to decrease the risk of motor response, but lower values might not prevent this response when the opioid concentration is insufficient, despite an adequate hypnosis.
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Multicenter Study
Risk factors of intraoperative oxygen desaturation: a case-control study of 152,314 anesthetics.
The present study was part of the Thai Anesthesia Incidents Study (THAI Study) of anesthetic adverse outcomes. ⋯ Knowing the risk factors of intraoperative oxygen desaturation helps improving personnel to improve preanesthetic conditions and facilitate early detection as well as prompt treatment of intraoperative oxygen desaturation.