Anesthesiology
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Comparative Study Clinical Trial Controlled Clinical Trial
Neural mechanisms of antinociceptive effects of hypnosis.
The neural mechanisms underlying the modulation of pain perception by hypnosis remain obscure. In this study, we used positron emission tomography in 11 healthy volunteers to identify the brain areas in which hypnosis modulates cerebral responses to a noxious stimulus. ⋯ Both intensity and unpleasantness of the noxious stimuli are reduced during the hypnotic state. In addition, hypnotic modulation of pain is mediated by the anterior cingulate cortex.
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Randomized Controlled Trial Comparative Study Clinical Trial
Airway management during spaceflight: A comparison of four airway devices in simulated microgravity.
The authors compared airway management in normogravity and simulated microgravity with and without restraints for laryngoscope-guided tracheal intubation, the cuffed oropharyngeal airway, the standard laryngeal mask airway, and the intubating laryngeal mask airway. ⋯ The emphasis placed on the use of restraints for conventional tracheal intubation in microgravity is appropriate. Extratracheal airway devices may be useful when restraints cannot be applied or intubation is difficult.
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Randomized Controlled Trial Clinical Trial
Extent of hyperbaric spinal anesthesia influences the duration of spinal block.
The influence of spread of spinal anesthesia on the duration of spinal blockade has been suggested but never investigated specifically. Because elimination of local anesthetic from subarachnoid space is probably dependent of the surface available for its diffusion and vascular absorption, the current study was designed to evaluate the hypothesis that with a same dose of hyperbaric bupivacaine, a higher anesthetic level would result in a shorter duration of spinal blockade than a lower level. ⋯ The results indicate that with the same dose of hyperbaric bupivacaine, the duration of spinal blockade is longer in patients with restricted spread.
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Maintenance of airway patency and oxygenation are the main objectives of face-mask ventilation. Because the incidence of difficult mask ventilation (DMV) and the factors associated with it are not well known, we undertook this prospective study. ⋯ In a general adult population, DMV was reported in 5% of the patients. A simple DMV risk score was established. Being able to more accurately predict DMV may improve the safety of airway management.
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Body temperature often is ignored during regional anesthesia, despite evidence that hypothermia occurs commonly. Because hypothermia is associated with adverse clinical outcomes, it is important to recognize predictors of hypothermia and to monitor and control body temperature in patients at risk. The current study was designed to determine the predictors of core hypothermia in patients receiving spinal anesthesia for radical retropubic prostatectomy. ⋯ Although high-level spinal blockade has been associated with decreased thermoregulatory thresholds, no previous study has shown that a higher level of blockade is associated with a greater magnitude of core hypothermia in the clinical setting. As with general anesthesia, advanced age is associated with hypothermia during spinal anesthesia.