Anesthesia and analgesia
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Anesthesia and analgesia · Jan 2009
Comparative Study Clinical TrialThe influence of arm abduction on the anatomic relations of infraclavicular brachial plexus: an ultrasound study.
Distances from brachial plexus to the coracoid process and the pleura are critical for performing infraclavicular block. We evaluated the influence of arm abduction on the position of the neurovascular bundle relative to the skin, to the coracoid process and to the pleura using ultrasonography. ⋯ Abduction of the arm reduces the depth of the brachial plexus but does not change the position of the axillary artery relative to the coracoid process or the pleura. Ultrasonography may under-estimate the actual depth of the plexus.
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Anesthesia and analgesia · Jan 2009
Randomized Controlled TrialThe efficacy of ilioinguinal-iliohypogastric and intercostal nerve co-blockade for postoperative pain relief in kidney recipients.
Postoperative pain is severe in patients undergoing renal transplantation. Systemic analgesia may produce complications as a result of impaired renal function. We investigated whether combined lower intercostal and Ilioinguinal-Iliohypogastric (IG-IH) nerve block might improve the quality of analgesia and reduce morphine consumption during the first 24 h after surgery. ⋯ Combined IG-IH and lower intercostal nerves blockade after renal transplantation significantly reduced postoperative pain and opioid consumption.
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Anesthesia and analgesia · Jan 2009
Comparative StudyThe feasibility of epicardial echocardiography for measuring aortic valve area by the continuity equation.
Measuring the aortic valve area (AVA) remains an important component of a comprehensive intraoperative echocardiographic examination in patients undergoing aortic valve surgery. Epicardial echocardiography (EE) represents an accessible alternative to transesophageal echocardiography (TEE), however, its agreement and correlation with other imaging modalities for measuring AVA has not been systematically validated. ⋯ EE measurements of AVA by the continuity equation show high agreement and closely correlate with established techniques of AVA assessment.
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Anesthesia and analgesia · Jan 2009
What determines the efficacy of forced-air warming systems? A manikin evaluation with upper body blankets.
Forced-air warming has gained acceptance as an effective means to prevent perioperative hypothermia. However, little is known about the influence of air flow and air temperature at the nozzle and the influence of heat distribution in the blankets on the efficacy of these systems. ⋯ The efficacy of forced-air warming systems is primarily determined by the blanket. Modern power units provide sufficient heat energy to maximize the ability of the blanket to warm the patient. Optimizing blanket design by optimizing the mean temperature gradient between the blanket and the manikin (or any other surface) with a very homogeneous temperature distribution in the blanket will enable the manufacturers to develop better forced-air warming systems.
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Anesthesia and analgesia · Jan 2009
Electrical noise in the intraoperative magnetic resonance imaging setting.
Intraoperative magnetic resonance imaging (iMRI) is a tool now commonly used in neurosurgery. Safe and reliable patient care in this (or any other) operating room setting depends on an environment, where electrical noise (EN) does not interfere with the operation of the electronic monitoring or imaging equipment. In this investigation, we evaluated the EN generated by the iMRI system and the anesthesia patient monitor used at this institution that impacts the performance of these two devices. ⋯ The EN generated by our anesthesia patient monitor is within acceptable limits for the iMRI system. The iMRI generates EN which renders the ECG unreadable in the most commonly used filter mode. The monitor's filters diminish this noise but also alter the morphology of the ECG waveform. The anesthesiologist must be cognizant of these technical compromises and recognize that adjusting the ECG filters on the monitor is required to obtain a useful ECG signal for patient monitoring during the iMRI scan but that the diagnostic value of the ECG will be reduced.