Anesthesia and analgesia
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Anesthesia and analgesia · Apr 1993
Comment Letter Comparative StudyORG 9426, succinylcholine or vecuronium: which agent provides "overall superiority" for short outpatient procedures.
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Anesthesia and analgesia · Apr 1993
Case Reports Comparative StudyComplete airway obstruction during arthroscopic shoulder surgery.
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Anesthesia and analgesia · Apr 1993
ReviewCerebral blood flow and metabolism during cardiopulmonary bypass.
Although much has been learned about cerebral physiology during CPB in the past decade, the role of alterations in CBF and CMRO2 during CPB and the unfortunately common occurrence of neuropsychologic injury still is understood incompletely. It is apparent that during CPB temperature, anesthetic depth, CMRO2, and PaCO2 are the major factors that effect CBF. The systemic pressure, pump flow, and flow character (pulsatile versus nonpulsatile) have little influence on CBF within the bounds of usual clinical practice. ⋯ It must be emphasized that not the absolute level of CBF, but the appropriateness of oxygen delivery to demand is paramount. However, the assumption that the control of cerebral oxygen and nutrient supply and demand will prevent neurologic injury during CPB is simplistic. A better understanding of CBF, CMRO2, autoregulation and mechanism(s) of cerebral injury during CPB has lead to a scientific basis for many of the decisions made regarding extracorporeal perfusion.
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Anesthesia and analgesia · Apr 1993
Randomized Controlled Trial Comparative Study Clinical TrialPropofol infusion and the incidence of emesis in pediatric outpatient strabismus surgery.
A prospective, randomized, double-blind study was conducted to examine the effect of a propofol infusion on the incidence of postoperative emesis in children undergoing outpatient strabismus surgery. Seventy-eight children, aged 3-12 yr, were allocated randomly to receive either nitrous oxide and halothane or nitrous oxide and a propofol infusion for the maintenance of anesthesia. ⋯ In children who received no opioids postoperatively, the incidence of vomiting in the first 24 h was 71% in the halothane group and 24% in the propofol group; this difference was also significant (P = 0.001). We conclude that propofol was effective in reducing the incidence of postoperative emesis in pediatric outpatient strabismus surgery.
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Anesthesia and analgesia · Apr 1993
Randomized Controlled Trial Comparative Study Clinical TrialDirect or modified Seldinger guide wire-directed technique for arterial catheter insertion.
Percutaneous radial artery cannulation is widely used for direct continuous arterial blood pressure measurement and sampling of arterial blood. We compared the success rate of arterial catheter placement in patients undergoing aortocoronary bypass operations using the direct and the modified Seldinger techniques. The effects of gender and quality of the pulse were also investigated. ⋯ We conclude that the success rate for cannulation is high in male patients, and patients with a bounding pulse regardless of the use of the direct or guide-wire techniques. The guide wire is recommended as the initial technique for cannulating the radial artery of female patients. In patients with a thready pulse, no significant advantage could be obtained by using a guide wire, but in salvaging an arterial line the guide wire is efficacious.