Anesthesiology
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Comment Letter Comparative Study
Low-dose versus a higher-dose bupivacaine spinal anesthesia for cesarean delivery.
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Randomized Controlled Trial Comparative Study
Nefopam and alfentanil additively reduce the shivering threshold in humans whereas nefopam and clonidine do not.
Induction of therapeutic hypothermia is often complicated by shivering. Nefopam reduces the shivering threshold with minimal side effects. Consequently, nefopam is an attractive component for induction of therapeutic hypothermia. However, nefopam alone is insufficient; it will thus need to be combined with another drug. Clonidine and alfentanil each reduce the shivering threshold. This study, therefore, tested the hypothesis that nefopam, combined either with clonidine or alfentanil, synergistically reduces the shivering threshold. ⋯ Nefopam and alfentanil additively reduce the shivering threshold, but nefopam and clonidine do not.
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Review Comparative Study
Hydroxyethyl starches: different products--different effects.
With the development of a new generation of hydroxyethyl starches (HES), there has been renewed interest in their clinical potential. High doses of first- and second-generation HES were associated with adverse effects on renal function, coagulation, and tissue storage, thereby limiting their clinical applicability. ⋯ These improvements have been achieved with no loss of efficacy, and they contradict the assumption that efficacy of HES solutions is directly linked to plasma concentration. The impact of source material on structure and pharmacokinetics is highlighted, and the role of the carrier solution is critically assessed.