Anesthesia and analgesia
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Anesthesia and analgesia · Oct 1994
Randomized Controlled Trial Clinical TrialPrevention of endotracheal tube-induced coughing during emergence from general anesthesia.
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Anesthesia and analgesia · Oct 1994
Randomized Controlled Trial Comparative Study Clinical TrialProspective comparison of use of the laryngeal mask and endotracheal tube for ambulatory surgery.
We examined the response to the laryngeal mask (LM) compared to the endotracheal tube (ETT) in patients undergoing ambulatory anesthesia. The differences in management by the anesthesiologists for these two airways were also examined. Peripheral orthopedic procedures were studied in 44 outpatients randomized to receive a LM or ETT, and either spontaneous or controlled ventilation. ⋯ The ETT was associated with greater hemodynamic response not only to airway placement (P < 0.05), but also to surgical incision (P < 0.05) and airway removal (P < 0.05). Spontaneous or controlled ventilation favored neither airway, although the ETT was associated with increased work of inspiration with controlled ventilation (P < 0.05). Anesthesiologists tended to elect smaller tidal volumes, faster ventilation rates, and lower anesthetic concentrations for patients with the LM (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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Anesthesia and analgesia · Oct 1994
Randomized Controlled Trial Clinical TrialClonidine decreases the dose of thiamylal required to induce anesthesia in children.
Clonidine is a useful drug to give preoperatively because it produces anxiolysis, sedation, and hemodynamic stability, and reduces intravenous and volatile anesthetic requirements. Several premedicants, including midazolam and diazepam, have been shown to reduce the induction dose of intravenous anesthetics, such as thiopental, ketamine, or propofol. A randomized, double-blind controlled study was conducted to evaluate the effect of premedication with oral clonidine on thiamylal requirement for the induction of anesthesia and on associated hemodynamic changes in children. ⋯ The induction dose of thiamylal (mean +/- SD) was 5.4 +/- 0.9, 4.5 +/- 1.1, and 3.4 +/- 0.9 mg/kg for patients receiving placebo, clonidine 2 micrograms/kg, and clonidine 4 micrograms/kg, respectively (P < 0.05). Systolic BP decreased by 6.8%, 5.6%, and 6.6% and HR increased by 5.7%, 4.8%, and 4.1% after administration of thiamylal in the control (placebo) group and the clonidine 2 micrograms/kg and clonidine 4 micrograms/kg groups, respectively (P > 0.05). Premedication with oral clonidine reduced the dose of intravenous thiamylal required for the induction of anesthesia in children.
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Anesthesia and analgesia · Oct 1994
Prevention of occupational transmission of human immunodeficiency virus and hepatitis B virus among anesthesiologists: a survey of anesthesiology practice.
In light of the increasing prevalence of the human immunodeficiency virus (HIV) and hepatitis B virus (HBV), anesthesiologists are now likely to see more patients who are at high risk for these viruses. Therefore, it is important that they adopt infection control policies aimed at preventing occupational transmission of these and other pathogens during their clinical practice. This study was designed, using a questionnaire format, to evaluate anesthesiologist compliance with Centers for Disease Control (CDC) guidelines for the prevention of occupational transmission of HIV and HBV. ⋯ However, anesthesiologists who reported recapping needles using the one-handed technique were less likely to sustain a needlestick injury than those who recapped using the two-handed technique. Thirty-one percent and 72% of respondents respectively reported a clean or contaminated needlestick within the preceeding 12 mo. Only 45.4% of those receiving a contaminated needlestick sought treatment.(ABSTRACT TRUNCATED AT 250 WORDS)