Anesthesia and analgesia
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Anesthesia and analgesia · Nov 2007
Randomized Controlled Trial Comparative StudyTransient neurological symptoms after isobaric subarachnoid anesthesia with 2% lidocaine: the impact of needle type.
The reported incidence of transient neurological symptoms (TNS) after subarachnoid lidocaine administration is as high as 40%. We designed this clinical trial to determine the incidence of TNS with two different pencil-point spinal needles: one-orifice (Atraucan) and two-orifice (Eldor) spinal needles. ⋯ The use of a double-orifice spinal needle was associated with a lower incidence of TNS, which may have been due to the needle design.
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Anesthesia and analgesia · Nov 2007
Comparative StudyEpidural anesthesia for laminectomy lead placement in spinal cord stimulation.
Spinal cord stimulation (SCS) is used to treat chronic pain and requires an awake patient for optimized lead positioning to locate paresthesias. Epidural anesthesia may be a suitable anesthetic but has not been evaluated. ⋯ This is the first study using epidural anesthesia for SCS lead implants by laminectomy. The technique seems to be safe and effective.
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Anesthesia and analgesia · Nov 2007
Randomized Controlled Trial Comparative StudyRecovery profiles of general anesthesia and spinal anesthesia for chemotherapeutic perfusion with circulatory block (stop-flow perfusion).
Chemotherapeutic stop-flow perfusion is a new investigational treatment for locally advanced cancers that is usually performed under general anesthesia (GA), and, less frequently, under spinal anesthesia (SA). We designed this clinical trial to compare the clinical profiles of GA and SA for stop-flow perfusion. ⋯ For stop-flow perfusion, GA and SA are both effective, but SA provides faster recovery, superior analgesia, and less postoperative nausea and vomiting in the immediate postoperative period.
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Anesthesia and analgesia · Nov 2007
Comparative StudyIntraoperative management of patients with carcinoid heart disease having valvular surgery: a review of one hundred consecutive cases.
Cardiac surgery for carcinoid heart disease is complicated by hemodynamic instability secondary to carcinoid crises, cardiovascular dysfunction, and blood loss. The safety of vasopressors and the benefit of aprotinin during concomitant octreotide administration are uncertain. ⋯ Vasopressors may be used in conjunction with octreotide in carcinoid patients. The increased mortality associated with epinephrine likely reflects selection bias rather than a primary adverse effect. The improved survival over time in carcinoid patients is multifactorial and unrelated to aprotinin administration, suggesting further inhibition of the kallikrein-kinin system has little added benefit for this outcome in the presence of octreotide.
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Anesthesia and analgesia · Nov 2007
Comparative StudyThe effects of different dobutamine infusion rates on hypercapnic depression of diaphragmatic contractility in pentobarbital-anesthetized dogs.
Previously, we demonstrated that dobutamine was more effective than dopamine for the improvement of diaphragmatic contractility during hypercapnia. Here, we studied the effects of different dobutamine infusion rates on hypercapnic depression of diaphragmatic contractility in pentobarbital-anesthetized dogs. ⋯ Dobutamine effectively improves hypercapnic depression of diaphragmatic contractility in an infusion rate-dependent manner in pentobarbital-anesthetized dogs.