Anesthesiology
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Randomized Controlled Trial Clinical Trial
Effects of morphine and tramadol on somatic and visceral sensory function and gastrointestinal motility after abdominal surgery.
Chronic nociceptive input induces sensitization and changes in regulatory reflexes in animal models. In humans, postoperative somatic and visceral sensitization and the secondary effects on reflex gut motility are unclear. ⋯ Pain control was equally effective with morphine and tramadol infusions. No somatic or visceral sensitization was evident during morphine and tramadol infusions, but pain tolerance thresholds as markers of antinociception were increased more during morphine infusions. The significant sensitization seen only after morphine discontinuation may be due to convergent visceral input. Gut motility was prolonged significantly by visceral surgery itself and also by morphine.
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Multicenter Study
A new noninvasive method to measure blood pressure: results of a multicenter trial.
Blood pressure (BP) monitoring with arterial waveform display requires an arterial cannula. We evaluated a new noninvasive device, Vasotrac (Medwave, Arden Hills, MN) that provides BP measurements approximately every 12-15 beats and displays pulse rate and a calibrated arterial waveform for each BP measurement. ⋯ In surgical and critically ill patients, the Vasotrac measured BP, pulse rate, and displayed radial artery waveform, which was similar to direct radial arterial measurements. It should be a suitable device to measure BP frequently in a noninvasive fashion.
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Randomized Controlled Trial Clinical Trial
Additive contribution of nitrous oxide to sevoflurane minimum alveolar concentration for tracheal intubation in children.
To study the interaction between nitrous oxide and sevoflurane during trachea intubation, the authors determined the minimum alveolar concentration of sevoflurane for tracheal intubation (MAC(TI)) with and without nitrous oxide in children. ⋯ We conclude that nitrous oxide and sevoflurane suppress the responses to tracheal intubation in a linear and additive fashion in children.
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Randomized Controlled Trial Comparative Study Clinical Trial
Preoxygenation: comparison of maximal breathing and tidal volume breathing techniques.
Preoxygenation with tidal volume breathing for 3-5 min is recommended by Hamilton and Eastwood. This report compares tidal volume preoxygenation technique with deep breathing techniques for 30-60 s. ⋯ Rapid preoxygenation with the eight deep breaths within 60 s can be used as an alternative to the traditional 3-min technique.
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Randomized Controlled Trial Clinical Trial
Clinical assessment of a plastic optical fiber stylet for human tracheal intubation.
The authors compared the performance of a prototype intubation aid that incorporated plastic illumination and image guides into a stylet with fiberoptic bronchoscopy and direct laryngoscopy for tracheal intubation by novice users. ⋯ Novices using the imaging stylet produce fewer cases of sore throat (compared with direct laryngoscopy) and can intubate faster than when using a bronchoscope in anesthetized adult patients. The imaging stylet may be a useful aid for tracheal intubation, especially for those unable to maintain skills with a bronchoscope.