Anesthesiology
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There are no adequate pharmacodynamic data relating concentrations of acetaminophen in serum to analgesia. ⋯ The pharmacodynamics of acetaminophen can be described using a sigmoidal Emax model with a low Hill coefficient. To achieve a mean posttonsillectomy pain score of 3.6 of 10, an effect compartment concentration of 10 mg/l is necessary.
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Randomized Controlled Trial Comparative Study Clinical Trial
Pulmonary airway resistance with the endotracheal tube versus laryngeal mask airway in paralyzed anesthetized adult patients.
The hypothesis that airway resistance is less with the laryngeal mask airway than with the endotracheal tube was tested. ⋯ The laryngeal mask airway triggers less bronchoconstriction than does the endotracheal tube in paralyzed anesthetized adult patients. This may have implications for maintaining intraoperative pulmonary function and reducing the risk for atelectasis and pulmonary infection.
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Randomized Controlled Trial Comparative Study Clinical Trial
Antiemetic prophylaxis does not improve outcomes after outpatient surgery when compared to symptomatic treatment.
Although prophylactic administration of antiemetics reduces the incidence of postoperative nausea, vomiting, or both (PONV), there is little evidence to suggest this improves patient outcomes. The authors hypothesized that early symptomatic treatment of PONV will result in outcomes, including time to discharge, unanticipated admission, patient satisfaction, and time to return to normal daily activities, that are similar to those achieved with routine prophylaxis. ⋯ Although PONV is unpleasant, the data indicate little difference in outcomes when routine prophylactic medications are administered versus simply treating PONV should symptoms occur.
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Randomized Controlled Trial Clinical Trial
Molar potency is predictive of the speed of onset of neuromuscular block for agents of intermediate, short, and ultrashort duration.
The times to peak effect of rocuronium, vecuronium, cisatracurium, mivacurium, and succinylcholine were evaluated to confirm that the correlation between potency and onset time observed for long-acting relaxants also held for drugs of intermediate and short duration. ⋯ The inverse correlation between the molar potency and speed of onset previously described for agents of long duration also applies to nondepolarizing agents of intermediate and short duration. The onset time of succinylcholine also appears to be compatible with this relation.