Anesthesia and analgesia
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Anesthesia and analgesia · May 2008
Randomized Controlled Trial Comparative StudyCombined general/epidural anesthesia (ropivacaine 0.375%) versus general anesthesia for upper abdominal surgery.
We designed this study to investigate the effect of 0.375% ropivacaine on stress hormone responses and anesthetic requirements in combined epidural/general anesthesia for nephrectomy. ⋯ Epidural ropivacaine 0.375% suppressed stress hormone responses and sufentanil requirements perioperatively during maintenance of anesthesia for nephrectomy.
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Anesthesia and analgesia · May 2008
Comparative StudyA comparison of the combination of epinephrine and vasopressin with lipid emulsion in a porcine model of asphyxial cardiac arrest after intravenous injection of bupivacaine.
In a porcine model, we compared the effect of the combination of vasopressin/epinephrine with that of a lipid emulsion on survival after bupivacaine-induced cardiac arrest. ⋯ In this model of a bupivacaine-induced cardiac arrest, the vasopressor combination of vasopressin and epinephrine compared with lipid emulsion resulted in higher coronary perfusion pressure during CPR and survival rates.
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Anesthesia and analgesia · May 2008
Poor visualization during direct laryngoscopy and high upper lip bite test score are predictors of difficult intubation with the GlideScope videolaryngoscope.
The GlideScope videolaryngoscope allows equal or superior glottic visualization compared with direct laryngoscopy, but predictive features for difficult GlideScope intubation have not been identified. We undertook this prospective study to identify patient characteristics associated with difficult GlideScope intubation. ⋯ Despite a high success rate, intubation with the GlideScope is likely to be more challenging in patients with high Cormack and Lehane grade during direct laryngoscopy, high upper lip bite test score, or short sternothyroid distance.
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Anesthesia and analgesia · May 2008
ReviewCoagulation monitoring: current techniques and clinical use of viscoelastic point-of-care coagulation devices.
Perioperative monitoring of blood coagulation is critical to better understand causes of hemorrhage, to guide hemostatic therapies, and to predict the risk of bleeding during the consecutive anesthetic or surgical procedures. Point-of-care (POC) coagulation monitoring devices assessing the viscoelastic properties of whole blood, i.e., thrombelastography, rotation thrombelastometry, and Sonoclot analysis, may overcome several limitations of routine coagulation tests in the perioperative setting. The advantage of these techniques is that they have the potential to measure the clotting process, starting with fibrin formation and continue through to clot retraction and fibrinolysis at the bedside, with minimal delays. ⋯ A surgical etiology of bleeding has to be considered when viscoelastic test results are normal. In summary, viscoelastic POC coagulation devices may help identify the cause of bleeding and guide pro- and anticoagulant therapies. To ensure optimal accuracy and performance, standardized procedures for blood sampling and handling, strict quality controls and trained personnel are required.