Anesthesia and analgesia
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Anesthesia and analgesia · Apr 2008
Randomized Controlled TrialA comparison of the end-tidal sevoflurane concentration for removal of the laryngeal mask airway and laryngeal tube in anesthetized children.
In this study we quantified and compared the optimal sevoflurane concentration required to prevent coughing or moving during or after removal of the laryngeal mask airway (LMA) and the laryngeal tube (LT) in anesthetized children. ⋯ LMA and LT removal in 95% of anesthetized children (aged 8 mo to 12 yr) can be safely accomplished without coughing, moving, or any other airway complications at 0.86 and 0.80 minimum alveolar anesthetic concentration, respectively, and a similar concentration should be used for removal of the LT or LMA in children.
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Anesthesia and analgesia · Apr 2008
Comparative StudyThe relationship between bispectral index and propofol during target-controlled infusion anesthesia: a comparative study between children and young adults.
In this prospective study, we compared the relationship between propofol concentrations and bispectral index (BIS) in children versus young adults anesthetized with target-controlled infusion (TCI) of propofol. ⋯ The good relationship between propofol and BIS demonstrated in children as in adults suggested a slightly lower sensitivity to propofol in children. As the predictability of plasma propofol concentrations with the classical pharmacokinetic/pharmacodynamic models is limited in children, a cerebral pharmacodynamic feedback, such as BIS, may be useful in this population.
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Anesthesia and analgesia · Apr 2008
Online monitoring of pulse pressure variation to guide fluid therapy after cardiac surgery.
The arterial pulse pressure variation induced by mechanical ventilation (deltaPP) has been shown to be a predictor of fluid responsiveness. Until now, deltaPP has had to be calculated offline (from a computer recording or a paper printing of the arterial pressure curve), or to be derived from specific cardiac output monitors, limiting the widespread use of this parameter. Recently, a method has been developed for the automatic calculation and real-time monitoring of deltaPP using standard bedside monitors. Whether this method is to predict reliable predictor of fluid responsiveness remains to be determined. ⋯ Automatic real-time monitoring of deltaPP is possible using a standard bedside monitor and was found to be a reliable method to predict fluid responsiveness after cardiac surgery. Additional studies are needed to determine if this technique can be used to avoid the complications of fluid administration in high-risk patients.
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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 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.