Anesthesia and analgesia
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Anesthesia and analgesia · May 2007
Comparative StudyPreexisting cognitive impairment in patients scheduled for elective coronary artery bypass graft surgery.
An accurate assessment of the prevalence of cognitive impairment in patients scheduled for coronary artery bypass graft (CABG) surgery is necessary if valid assumptions regarding cognitive change are to be made. Such an assessment requires the use of a healthy control group free of cardiovascular disease. ⋯ Cognitive impairment is prevalent in patients presenting for CABG surgery. Impaired cognition before surgery must be considered when assessing the effects of CABG surgery on cognitive performance.
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Anesthesia and analgesia · May 2007
Comparative StudyThe effects of systemic lidocaine on airway tone and pulmonary function in asthmatic subjects.
To prevent reflex-induced bronchoconstriction in patients with asthma, local anesthetics are commonly administered by aerosol or IV as adjunct medication. Lidocaine attenuates responsiveness to a neurally active stimulus that increases tone, but there is scant information about the effect of lidocaine on baseline airway tone. Therefore we examined the effects of IV lidocaine on baseline airway tone in asthmatic subjects. ⋯ Lidocaine, which reduces airway responsiveness to drugs that cause bronchospasm through sensory nerve activation, did not reduce baseline airway tone. Instead, even when administered IV, lidocaine significantly increased airway tone and caused airway narrowing. Therefore, while the administration of lidocaine can prevent intubation-induced bronchospasm, the airways should be constantly monitored by auscultation even during IV lidocaine administration.
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Anesthesia and analgesia · May 2007
Comparative StudyUltrasound using the transverse approach to the lumbar spine provides reliable landmarks for labor epidurals.
Ultrasound imaging of the spine has recently been proposed to facilitate identification of the epidural space. In this study, we assessed the accuracy and precision of the transverse approach, using a "single-screen" method, to facilitate labor epidurals. ⋯ We found a good level of success in the ultrasound-determined insertion point, and very good agreement between UD and ND. This suggests that our proposed ultrasound single-screen method, using the transverse approach, can be a reliable guide to facilitate labor epidural insertion.
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Anesthesia and analgesia · May 2007
Case ReportsCesarean delivery in the interventional radiology suite: a novel approach to obstetric hemostasis.
The adjunctive use of interventional radiology procedures to minimize and control bleeding at the time of cesarean delivery has become increasingly common. These procedures require modern imaging equipment and supplies not available in traditional operating rooms. ⋯ We propose that this novel surgical location is feasible, and may offer advantages in select patients.