Anesthesia and analgesia
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Anesthesia and analgesia · Jan 2008
Randomized Controlled TrialThe effect of detailed, video-assisted anesthesia risk education on patient anxiety and the duration of the preanesthetic interview: a randomized controlled trial.
Video-assisted patient education during the preanesthetic clinic visit is a new intervention to increase knowledge transfer to the patient regarding anesthesia procedure and risks. However, little is known about whether video-based patient education influences patient anxiety and the duration of the preanesthetic visit. ⋯ Our study suggests that the use of a video for detailed anesthesia risk education does not change patient anxiety, but leads to a better understanding of the procedure and risks of anesthesia. When the video is shown before the preanesthetic interview, the interview is longer.
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Anesthesia and analgesia · Jan 2008
Randomized Controlled TrialPreoperative gabapentin: the effect on ropivacaine subarachnoid block and hemodynamics.
Gabapentin is an adjuvant analgesic and may enhance the spread of subarachnoid block. We investigated the effects of pretreatment with gabapentin on subarachnoid block characteristics and hemodynamics. ⋯ Pretreatment with gabapentin had no effect on the spread of sensory block or the regression of motor block but was associated with lower systolic arterial blood pressure values in patients undergoing subarachnoid anesthesia with ropivacaine.
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Anesthesia and analgesia · Jan 2008
Case ReportsNonfatal cerebral air embolism after dental surgery.
After removal of four impacted third molars under general anesthesia, our patient developed subcutaneous emphysema, pneumothorax, pneumopericardium, and pneumomediastinum. Soon thereafter, coma with generalized epileptic status ensued. ⋯ The likely mechanism was injection of air by the high-speed dental drill through the soft tissue adjacent to the roots of the lower molars. We were unable to find any previous report of systemic air embolism after oral surgery.
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Anesthesia and analgesia · Jan 2008
Comparative StudyA comparison of two emergency cricothyroidotomy kits in human cadavers.
We compared two emergency cricothyroidotomy kits designed to avoid lesions during insertion, one based on the Seldinger technique (ST), the other based on the concept of a mechanical detection of the posterior wall of the larynx, with regard to insertion time, success rate, and complication rate. ⋯ In this model, despite a shorter insertion time, the NT produced more lesions and more failures than the ST.
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Anesthesia and analgesia · Jan 2008
Comparative StudyIntracardiac transvenous echocardiography is superior to both precordial Doppler and transesophageal echocardiography techniques for detecting venous air embolism and catheter-guided air aspiration.
Venous air embolism (VAE) is a potentially fatal complication during surgical procedures with patients in the sitting position. Since methods for detection of persistent low-volume VAE and targeted air aspiration are limited, we tested the hypotheses that transvenous intracardiac echocardiography (ICE) 1) improves detection of small air emboli in comparison to transesophageal echocardiography (TEE) and precordial Doppler monitoring (PCD) techniques, and that 2) image-guided multiorifice central venous catheter manipulation improves air recovery in moderate and large VAE, when compared with aspiration with the multiorifice central venous catheter in a static position. ⋯ Small air emboli are detected by ICE with much greater sensitivity compared with both PCD and TEE techniques. Furthermore, recovery of embolized air is enhanced by image-guided manipulation of a multiorifice central venous catheter. Clinical studies are required to assess this technique during surgery with patients in the sitting position.