Anesthesiology
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Comparative Study Clinical Trial
The pharmacology of sevoflurane in infants and children.
Sevoflurane is a new volatile anesthetic with physical properties that should make it suitable for anesthesia (MAC of sevoflurane on oxygen alone and in 60% nitrous oxide, (MAC) of sevoflurane in oxygen alone and in 60% nitrous oxide, the hemodynamic, induction and emergence responses to sevoflurane and the metabolism to inorganic fluoride were studied in 90 ASA physical status 1 or 2 neonates, infants, and children. ⋯ We conclude that sevoflurane appears to be a suitable anesthetic agent for use in neonates, infants and children undergoing < or = 1 h of anesthesia.
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Comparative Study Clinical Trial
Cardiac output by transesophageal echocardiography using continuous-wave Doppler across the aortic valve.
The use of transesophageal echocardiography for the determination of cardiac output (CO) has been limited to date. We assessed the capability of aortic continuous-wave Doppler transesophageal echocardiography to determine CO (DCO) in a transgastric long-axis imaging plane of the heart by comparing DCO to thermodilution CO (TCO). ⋯ Compared to thermodilution, continuous-wave Doppler measurements of blood flow velocity across the aortic valve in the transesophageal echocardiographic transgastric view allow accurate CO determination.
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Clinical Trial Controlled Clinical Trial
Minimum alveolar concentration of isoflurane for tracheal extubation in deeply anesthetized children.
The end-tidal anesthetic gas concentration required to prevent the anesthetized patient from coughing or moving during or immediately after tracheal extubation is not known. ⋯ In 50% of anesthetized children age 4-9 yr tracheal extubation may be accomplished without coughing or moving at 1.27% end-tidal isoflurane concentration.
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The aim of this study was to investigate propofol's effect on myocardial contractility and relaxation and examine its underlying mechanism of action in isolated ferret ventricular myocardium. ⋯ These findings suggest that the negative inotropic effect of propofol results from a decrease in intracellular Ca++ availability with no changes in myofibrillar Ca++ sensitivity. At least part of propofol's action is attributable to inhibition of transsarcolemmal Ca++ influx.