Anesthesia and analgesia
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Anesthesia and analgesia · Jun 1997
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of propofol with a propofol-ketamine combination for sedation during spinal anesthesia.
Propofol (P) is increasingly used as a sedative during regional anesthesia. Providing titratable sedation and rapid recovery, it can compromise hemodynamic stability. However, in combination with ketamine (K), it provides stable hemodynamics during total intravenous anesthesia, avoiding emergence phenomena. ⋯ Mean arterial pressure was significantly higher in the P + K group, e.g., 91 mm Hg (86-94) vs 75 mm Hg (69-83) at 30 min (mean +/- SD). Administration of vasopressors and fluids as well as recovery and emergence phenomena were similar between groups. Although the described additive effect of propofol and ketamine was not confirmed, the combination conferred hemodynamic stability during spinal anesthesia.
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Anesthesia and analgesia · Jun 1997
Comparative StudyThe effect of xenon on spinal dorsal horn neurons: a comparison with nitrous oxide.
We compared the effects of xenon (Xe) on the spinal cord dorsal horn neurons with those of nitrous oxide (N2O) in cats anesthetized with chrolarose and urethane. We assessed the potency of both anesthetics by the inhibition of wide dynamic range neuron responses evoked by cutaneous noxious (pinch) stimulation to a hindpaw. During 70% Xe inhalation, the responses of 7 of 11 neurons to pinch stimulation were suppressed. ⋯ After 20 min of Xe inhalation, the response to pinch was suppressed to 49.5% +/- 8.2% (mean +/- SE), while N2O, 70% in oxygen, suppressed it to 45.9% +/- 7.9%. The difference between N2O and Xe was not significant. We conclude that Xe and N2O suppress the spinal cord dorsal horn neurons to a similar degree.
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Anesthesia and analgesia · Jun 1997
Clinical TrialDisplacement of the double-lumen endobronchial tube can be detected by bronchial cuff pressure change.
We measured the bronchial cuff pressure of left-sided double-lumen endobronchial tubes (DLTs) in 54 patients to confirm the effect of DLT displacement on cuff pressure. After positioning the cephalad surface of the bronchial cuff of the DLT 2.5 cm distal to the carina (23 patients in the first part of the study) or just below the carina (23 patients in the second part), the cuff was withdrawn in 0.5-cm steps during right-sided, one-lung ventilation. The bronchial cuff pressure was measured, and the capnogram and pressure-volume loop, displayed by a side-stream spirometer, was evaluated. ⋯ The bronchial cuff pressure decreased significantly by 28.4 cm H2O (P < 0.01) and 21.3 cm H2O (P < 0.01) in the first and second parts, respectively, before the pressure-volume loop or the capnogram changed. The bronchial cuff pressure in the third part showed no significant change. We conclude that bronchial cuff pressure monitoring was very helpful in detecting displacement of the DLT during right-sided, one-lung ventilation.