Anesthesiology
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Comparative Study
The effect of cricoid pressure on preventing gastric insufflation in infants and children.
The use of cricoid pressure for the possible prevention of regurgitation of gastric contents during induction of anesthesia in both adults and children has been recommended. However, equally important is the technique in possibly preventing insufflation of gas into the stomach. This study was designed to determine the efficacy of cricoid pressure application in preventing gastric gas insufflation in pediatric patients and to determine the airway pressure at which gas entered the stomach (pop-off point). ⋯ Appropriate application of cricoid pressure prevents gastric gas insufflation during airway management via mask up to 40 cm H2O PIP in infants and children. An additional benefit of cricoid pressure occurs in paralyzed patients in whom gastric insufflation occurs at lower inflation pressures.
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Randomized Controlled Trial Comparative Study Clinical Trial
Postoperative pulmonary complications. Epidural analgesia using bupivacaine and opioids versus parenteral opioids.
Different types of analgesia have been proposed for the prevention of postoperative respiratory complications. The aim of this prospective, double-blind randomized study was to compare the impact of epidural bupivacaine and opioids versus parenteral opioids on respiratory complications in patients who had undergone major abdominal surgery. ⋯ Epidural analgesia with a combination of local anesthetic and opioid improves patient comfort. However, this type of analgesia does not decrease the incidence of postoperative pulmonary complications, does not reduce the length of the hospital stay, and carries the risk of complications from episodic systemic hypotension.
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Randomized Controlled Trial Comparative Study Clinical Trial
The effect of flumazenil on midazolam-induced depression of the ventilatory response to hypoxia during isohypercarbia.
While flumazenil reverses benzodiazepine-induced sedation, its ability to antagonize the ventilatory depressant effects of benzodiazepines has not been fully established. A randomized, double-blind study was conducted to determine whether flumazenil effectively reverses midazolam-induced depression of the hypoxic ventilatory response. ⋯ It was concluded that, after sedation with midazolam, flumazenil causes a greater increase in hypoxic ventilatory response during isohypercarbic conditions than does placebo, and may, therefore, be useful in the treatment of midazolam-induced ventilatory depression.