Anesthesia and analgesia
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Anesthesia and analgesia · Sep 2004
Flow rates and warming efficacy with Hotline and Ranger blood/fluid warmers.
The heating capabilities of a water bath blood/fluid warmer, Hotline, have proven superior to those of other devices. The dry heat warmer Ranger has not previously been compared with the Hotline. We evaluated these devices in terms of flow rates and efficacy of warming. ⋯ Hotline was able to deliver warmer RBCs and saline at slower flow rates (1-4 L/h), but because changes in MBT were almost identical, there was no clinically important advantage, and almost no heat was transferred at these slower flow rates. At more rapid flow rates (>4 L/h), the Ranger warmed RBCs and saline better and produced smaller decreases in MBT than the Hotline. The use of the Hotline for rapid infusions, especially of cold RBCs, is not recommended because of low outflow temperatures and decreases in MBT that were three times larger than those seen with the Ranger.
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Anesthesia and analgesia · Sep 2004
Case ReportsKetamine for long-term sedation and analgesia of a burn patient.
We present a case in which ketamine was used for long-term sedation and analgesia of a burn patient. Under escalating opiate dosages, the patient had developed persistent ileus as well as abdominal distension that caused respiratory compromise, without receiving sufficient analgesia. ⋯ The quality of sedation also changed favorably. There were no obvious adverse effects of ketamine.
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Anesthesia and analgesia · Sep 2004
The effect of insulin on the resuscitation of bupivacaine-induced severe cardiovascular toxicity in dogs.
Resuscitation after bupivacaine-induced cardiovascular collapse is difficult and often resistant to conventional treatment. We tested the hypothesis that insulin treatment would effectively reverse bupivacaine-induced cardiovascular collapse in pentobarbital-anesthetized dogs. Bupivacaine was administered at 0.5 mg. kg(-1). min(-1) until mean arterial blood pressure decreased to 40 mm Hg or less. ⋯ In contrast to the control group, all IGK dogs survived. Mean arterial blood pressure, heart rate, cardiac output, mixed venous oxygen saturation, and end tidal CO(2) recovered toward baseline levels in the IGK group. In conclusion, severe bupivacaine-induced cardiovascular collapse in dogs was effectively reversed with the insulin treatment.