Anesthesiology
-
Randomized Controlled Trial Comparative Study Clinical Trial
Popliteal sciatic perineural local anesthetic infusion: a comparison of three dosing regimens for postoperative analgesia.
This randomized, double-blind study investigated the efficacy of continuous and patient-controlled ropivacaine infusion via a popliteal sciatic perineural catheter in ambulatory patients undergoing moderately painful orthopedic surgery of the foot or ankle. ⋯ This study demonstrates that when providing analgesia with 0.2% ropivacaine via a popliteal sciatic perineural catheter after moderately painful surgery of the foot or ankle, a continuous infusion is required to optimize infusion benefits. Furthermore, adding patient-controlled bolus doses allows for a lower continuous basal rate and decreased local anesthetic consumption and thereby increases the duration of infusion benefits when in an ambulatory environment with a limited local anesthetic reservoir.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Information loss over time defines the memory defect of propofol: a comparative response with thiopental and dexmedetomidine.
Sedative-hypnotic drugs impair memory, but details regarding the nature of this effect are unknown. The influences of propofol, thiopental, and dexmedetomidine on the performance of a task that isolates specific components of episodic memory function were measured. ⋯ Lack of retention of material acquired into long-term memory during propofol administration, associated with minimal sedation, seems to define drug-induced amnesia. Sedation seems to impair the acquisition or encoding of material into long-term memory. Therefore, the putative targets of drug-induced amnesia by propofol are processes associated with retention of material in long-term memory.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Teaching residents pediatric fiberoptic intubation of the trachea: traditional fiberscope with an eyepiece versus a video-assisted technique using a fiberscope with an integrated camera.
The authors' hypothesis was that a video-assisted technique should speed resident skill acquisition for flexible fiberoptic oral tracheal intubation (FI) of pediatric patients because the attending anesthesiologist can provide targeted instruction when sharing the view of the airway as the resident attempts intubation. ⋯ The video system seems to be superior for teaching residents fiberoptic intubation in children.
-
Randomized Controlled Trial Clinical Trial
Topical humidified carbon dioxide to keep the open surgical wound warm: the greenhouse effect revisited.
Perioperative hypothermia is common in open surgery and is associated with increased rates of wound infection. This is a result of decreased wound tissue oxygenation, which can be normalized by local warming. Recently, a technique has been developed to establish a carbon dioxide atmosphere in an open surgical wound. Therefore, the authors studied the possible "greenhouse effect" of carbon dioxide insufflation and operation lamps on wound temperature. ⋯ Insufflation of humidified carbon dioxide in combination with light from the operation lamps may help to keep the open wound warm during surgery.