Anesthesia and analgesia
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Anesthesia and analgesia · Aug 2007
Randomized Controlled Trial Comparative StudyClonidine 1 microg/kg is a safe and effective adjuvant to plain bupivacaine in spinal anesthesia in adolescents.
Spinal anesthesia is increasingly used in adolescents. However, the anesthesia provided by bupivacaine alone may be too short for the planned surgery. The addition of clonidine 2 microg/kg to bupivacaine provides a prolonged anesthetic action but may be associated with hypotension. In the present study, we investigated the efficacy and safety of intrathecal clonidine 1 mug/kg in adjunction to bupivacaine in spinal anesthesia in adolescents. ⋯ In adolescents, clonidine 1 microg/kg prolonged the duration of sensory block achieved with bupivacaine by 30 min and postoperative analgesia by 120 min without severe adverse events.
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Anesthesia and analgesia · Aug 2007
Multicenter Study Comparative StudyFactors predictive of patient satisfaction with anesthesia.
In this multicenter prospective study, we identified factors associated with satisfaction with anesthesia in patients staying in hospital at least 24 h after surgery. ⋯ Inpatient satisfaction can be improved by an organization in which surgical suite nurses are dedicated only to anesthesia, a written anesthesia information leaflet is given during the preoperative visit and postoperative visits are enhanced.
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Anesthesia and analgesia · Aug 2007
Randomized Controlled Trial Comparative StudyThe effect of leaving dentures in place on bag-mask ventilation at induction of general anesthesia.
The optimum timing for denture removal in edentulous patients before anesthesia and surgery is uncertain. ⋯ We conclude that bag-mask ventilation is easier in edentulate patients when their dentures are left in situ during induction of general anesthesia.
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Anesthesia and analgesia · Aug 2007
Comparative StudyThe frequency of anesthesia-related cardiac arrests in patients with congenital heart disease undergoing cardiac surgery.
The frequency of anesthesia-related cardiac arrests during pediatric anesthesia has been reported between 1.4 and 4.6 per 10,000 anesthetics. ASA physical status >III and younger age are risk factors. Patients with congenital cardiac disease may also be at increased risk. Therefore, in this study, we evaluated the frequency of cardiac arrest in patients with congenital heart disease undergoing cardiac surgery at a large pediatric tertiary referral center. ⋯ The frequency of anesthesia-related cardiac arrest in patients undergoing cardiac surgery is increased, but is not associated with an increase in mortality. Neonates and infants are at higher risk. Careful preparation and anticipation is important to ensure timely and effective resuscitation.
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Anesthesia and analgesia · Aug 2007
Comparative StudyAnesthetic preconditioning combined with postconditioning offers no additional benefit over preconditioning or postconditioning alone.
Recent investigations demonstrate that anesthetic preconditioning and postconditioning reduce myocardial infarct size to a degree comparable to that achieved with ischemic preconditioning. We hypothesized that the combination of sevoflurane preconditioning and postconditioning would result in greater preservation of myocardium. ⋯ Sevoflurane postconditioning is as effective as preconditioning in protecting myocardial function after global ischemia. The combination of sevoflurane preconditioning and postconditioning offered no additional benefit over either intervention alone.