Anesthesia and analgesia
-
Anesthesia and analgesia · Jan 2009
An evaluation of the epidural catheter position by epidural nerve stimulation in conjunction with continuous epidural analgesia in adult surgical patients.
The epidural stimulation test to confirm epidural catheter position has been described as being simple, fast, and reliable. We evaluated the feasibility of the epidural stimulation test and its potential in contributing to effective postoperative continuous epidural analgesia. ⋯ The epidural stimulation test was often associated with technical difficulties and interpretation problems. The role of the repeated use of the epidural stimulation test for quality assurance in patients undergoing postoperative continuous epidural analgesia remains undetermined.
-
Anesthesia and analgesia · Jan 2009
Randomized Controlled TrialAlveolar recruitment and arterial desflurane concentration during bariatric surgery.
We investigated whether reversal of intraoperative atelectasis with the lung recruitment maneuver (RM) affects desflurane arterial concentrations during bariatric surgery. ⋯ Although the RM during bariatric surgery represents an effective method for improving intraoperative oxygenation, it does not significantly affect the desflurane blood concentrations during anesthesia or its elimination during emergence.
-
Anesthesia and analgesia · Jan 2009
Review Case ReportsLeft ventricular assist device outflow cannula obstruction by the rare environmental fungus Myceliophthora thermophila.
Left ventricular assist devices are used to provide mechanical circulatory support during end-stage heart failure either as a destination therapy or as a bridge to heart transplantation. Perioperative transesophageal echocardiography is becoming an invaluable tool to investigate device function during implantation and in case of mechanical malfunction. ⋯ Here, we present a case of severe outflow conduit obstruction by a rare environmental fungus, Myceliophthora thermophila. After replacement of the infected device and intensive antifungal treatment, heart transplantation was performed 2 yr later.
-
Anesthesia and analgesia · Jan 2009
Randomized Controlled Trial Comparative StudyThe efficacy of a resistive heating under-patient blanket versus a forced-air warming system: a randomized controlled trial.
We compared temperature changes in patients undergoing hip replacement during warming with a resistive heating blanket or air-forced system. ⋯ We demonstrated that, using either a resistive heating-blanket or forced-air warming systems, patients ended surgery in mild hypothermia after elective total hip replacement, but without significant differences between these two warming devices.
-
Anesthesia and analgesia · Jan 2009
Comparative Study Clinical TrialArteriovenous differences in plasma dilution and the distribution kinetics of lactated ringer's solution.
Conventional concept suggests that infused crystalloid fluid is first distributed in the plasma volume and then, since the capillary permeability for fluid is very high, almost instantly equilibrates with the extracellular fluid space. We challenge whether this view is consistent with findings based on volume kinetic analysis. ⋯ The relatively slow whole-body distribution of lactated Ringer's solution, which boosts the plasma volume expansion during and for up to 30 min after an infusion, is probably governed by a joint effect of capillary permeability and differences in tissue perfusion between body regions.