Anesthesiology
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Letter Case Reports
Respiratory arrest after second dose of intrathecal sufentanil.
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Randomized Controlled Trial Clinical Trial
The pharmacodynamic interaction of propofol and alfentanil during lower abdominal surgery in women.
Propofol and alfentanil are frequently combined to provide general anesthesia. The purpose of this study was to characterize the pharmacodynamic interaction between propofol and alfentanil for several clinically relevant end points. ⋯ We defined the pharmacodynamic interaction between propofol and alfentanil for suppression of responses to perioperative stimuli during lower abdominal surgery. We conclude that propofol reduces alfentanil requirements for all studied clinical end points. In addition, alfentanil decreases propofol concentrations at which patients regain consciousness.
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Randomized Controlled Trial Clinical Trial
Dynamic and static cerebral autoregulation during isoflurane, desflurane, and propofol anesthesia.
Although inhalation anesthetic agents are thought to impair cerebral autoregulation more than intravenous agents, there are few controlled studies in humans. ⋯ At 1.5 MAC, isoflurane and desflurane impaired autoregulation whereas propofol (200 micrograms.kg-1.min-1) preserved it.
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When local anesthetic is used to produce epidural anesthesia intraoperatively, epidural catheter placement is confirmed. However, when epidural catheters are placed intraoperatively only to provide postoperative opioid analgesia, correct catheter placement may not be confirmed by administration of a local anesthetic. The current study tests the hypothesis that the extent of sensory blockade produced by a 10-ml dose of 1.5% lidocaine can be used to predict the adequacy of epidural opioid analgesia. ⋯ Extensive sensory block from 10 ml 1.5% lidocaine was associated with excellent epidural opioid analgesia. Extent of analgesia after a 10-ml test dose of 1.5% lidocaine can be used to predict the adequacy of analgesia resulting from an epidural opioid infusion. The failure of a local anesthetic dose to produce sensory blockade does not necessarily predict a failure to produce analgesia from an epidural opioid infusion, as indicated by the presence of analgesia in several patients without detectable sensory block.