Anesthesia and analgesia
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Anesthesia and analgesia · Apr 2009
Randomized Controlled TrialThe effect of melatonin on sleep quality after laparoscopic cholecystectomy: a randomized, placebo-controlled trial.
In this study, we investigated whether melatonin administration could improve postoperative subjective sleep quality and reduce discomfort. ⋯ Melatonin did not improve subjective sleep quality or discomfort compared with placebo after laparoscopic cholecystectomy.
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Anesthesia and analgesia · Apr 2009
Comparative StudyTime to a 90% change in gas concentration: a comparison of three semi-closed anesthesia breathing systems.
The speed with which gas concentration can be changed in the anesthesia breathing system affects the rate of denitrogenation, anesthesia induction, and emergence. Breathing system design also affects the speed at which gas concentration can be changed during maintenance. In this study, we sought to determine the speed of changes in gas concentration in modern semi-closed breathing systems. We hypothesized that equilibrium would be reached most quickly in breathing systems with smaller volume, and at high fresh gas flows. ⋯ We concluded that, other than fresh gas flow rate, breathing system volume has the biggest effect on time to equilibrium when the composition of the fresh gas inflow is changed. The position of components (e.g., valves, carbon dioxide absorber, fresh gas inlet, ventilator bellows or piston) within the breathing system has a less pronounced effect.
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Anesthesia and analgesia · Apr 2009
Comparative StudyIntralipid infusion diminishes return of spontaneous circulation after hypoxic cardiac arrest in rabbits.
Infusion of lipid emulsion has been shown to reverse lipophilic drug-induced cardiovascular collapse in laboratory models and humans. The effect of high dose lipid in nondrug-induced cardiac arrest is, however, uncertain. In a rabbit model of asphyxial pulseless electrical activity (PEA) we compared lipid augmented with standard advanced cardiac life support (ACLS) resuscitation. ⋯ In this model of hypoxia-induced PEA, standard ACLS resulted in greater coronary perfusion pressure and increased ROSC compared with ACLS plus lipid infusion. Lipid emulsion may be contraindicated in cardiac arrest complicated by significant hypoxia.
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Anesthesia and analgesia · Apr 2009
The effects of spinal anesthesia on cerebral blood flow in the very elderly.
Aging and disease may make elderly patients particularly susceptible to hypotension during spinal anesthesia. However, the impact of small-dose bupivacaine on cerebral hemodynamics is not known. In this study, we assessed the effects of spinal anesthesia on cerebral blood flow (CBF) in very elderly patients. ⋯ In summary, spinal anesthesia results in a very small but statistically significant reduction of CBF velocity in very elderly patients.