Anesthesia and analgesia
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Anesthesia and analgesia · Apr 2008
The importance of increased neck circumference to intubation difficulties in obese patients.
Using the intubation difficulty scale (IDS), we sought to confirm that obese patients are more difficult to intubate than lean patients. We assessed classical bedside tests and included neck circumference. ⋯ We found that problematic intubation was associated with thyromental distance, increasing neck circumference, BMI, and a Mallampati score of > or = 3. Neck circumference should be assessed preoperatively to predict difficult intubation.
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Anesthesia and analgesia · Apr 2008
Randomized Controlled TrialThe effects of intravenous granisetron on the sensory and motor blockade produced by intrathecal bupivacaine.
We hypothesized that pretreatment with i.v. granisetron would affect the sensory and motor components of spinal blockade through 5-HT(3) receptor blockade. ⋯ We concluded that i.v. granisetron facilitated a faster recovery of sensory block after bupivacaine subarachnoid anesthesia.
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Anesthesia and analgesia · Apr 2008
Randomized Controlled TrialThe predictive performance of a pharmacokinetic model for manually adjusted infusion of liquid sevofluorane for use with the Anesthetic-Conserving Device (AnaConDa): a clinical study.
The Anesthetic-Conserving Device (AnaConDa) can be used to administer inhaled anesthetics using an intensive care unit (ICU) ventilator. We evaluated the predictive performance of a simple manually adjusted pump infusion scheme, for infusion of liquid sevoflurane to the AnaConDa. ⋯ There is an excellent 6-h predictive performance of a simplified pharmacokinetic model for manually adjusted infusion of liquid sevoflurane when using the AnaConDa to deliver sevoflurane to ICU patients.
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Anesthesia and analgesia · Apr 2008
Intravascular injection in lumbar medial branch block: a prospective evaluation of 1433 injections.
The successful outcome and validity of lumbar medial branch block (MBB) are largely dependent on technique accuracy. Intravascular uptake of injectate causes a false-negative response to block and is associated with various possible complications. In the current study, we prospectively evaluated the incidence of, and the factors associated with, intravascular injection during block. In addition, we assessed the efficiencies of generally accepted safety measures, such as preinjection aspiration and intermittent fluoroscopy to avoid intravascular injections. ⋯ The aspiration test with or without spot radiography frequently missed the intravascular uptake of contrast during lumbar MBBs. We strongly advocate the use of real-time fluoroscopy during contrast injection to increase diagnostic and therapeutic value and to avoid possible complications.
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Anesthesia and analgesia · Apr 2008
Dermatome variation of lumbosacral nerve roots in patients with transitional lumbosacral vertebrae.
The presence of a transitional vertebra can create difficulty in identifying the lumbar level corresponding to an exiting nerve root at the time of a spinal nerve block. We investigated the possibility that the muscle innervation pattern and sensory dermatomes of the lumbar nerve roots are altered when a lumbosacral transitional vertebra is present using electrical stimulation. ⋯ Our findings suggest that the function of the lumbosacral nerve roots is altered in patients with a sacralized L5, and that the L4 nerve root serves the usual function of the L5 nerve root.