Anesthesia and analgesia
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Anesthesia and analgesia · Oct 2010
Randomized Controlled Trial Comparative StudyDexmedetomidine infusion for analgesia and prevention of emergence agitation in children with obstructive sleep apnea syndrome undergoing tonsillectomy and adenoidectomy.
Dexmedetomidine, a specific α(2) agonist, has an analgesic-sparing effect and reduces emergence agitation. We compared an intraoperative dexmedetomidine infusion with bolus fentanyl to reduce perioperative opioid use and decrease emergence agitation in children with obstructive sleep apnea syndrome undergoing adenotonsillectomy (T&A). ⋯ An intraoperative infusion of dexmedetomidine combined with inhalation anesthetics provided satisfactory intraoperative conditions for T&A without adverse hemodynamic effects. Postoperative opioid requirements were significantly reduced, and the incidence and duration of severe emergence agitation was lower with fewer patients having desaturation episodes.
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Anesthesia and analgesia · Oct 2010
Randomized Controlled Trial Comparative StudyEstimation and pharmacodynamic consequences of the minimum effective anesthetic volumes for median and ulnar nerve blocks: a randomized, double-blind, controlled comparison between ultrasound and nerve stimulation guidance.
Nerve stimulation and ultrasound guidance are the most popular techniques for peripheral nerve blocks. However, the minimum effective anesthetic volume (MEAV) in selected nerves for both techniques and the consequences of decreasing the local anesthetic volume on the pharmacodynamic characteristics of nerve block remain unstudied. We designed a randomized, double-blind controlled comparison between neurostimulation and ultrasound guidance to estimate the MEAV of 1.5% mepivacaine and pharmacodynamics in median and ulnar nerve blocks. ⋯ Ultrasound guidance selectively provided a 50% reduction in the MEAV of mepivacaine 1.5% for median nerve sensory blockade in comparison with neurostimulation. Decreasing the local anesthetic volume can decrease sensory block duration but not onset time.
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Anesthesia and analgesia · Oct 2010
Randomized Controlled Trial Comparative StudyStrepsils® tablets reduce sore throat and hoarseness after tracheal intubation.
Amyl-m-cresol (Strepsils®) has been successfully used in the prophylaxis and treatment of oral inflammations, but its effects on postintubation sore throat and hoarseness are unknown. We conducted this study to evaluate the effects of Strepsils in reducing postintubation sore throat and hoarseness. ⋯ Perioperative use of Strepsils tablets reduces postoperative sore throat and hoarseness of voice.
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Anesthesia and analgesia · Oct 2010
Comparative StudyLung recruitment and positive end-expiratory pressure have different effects on CO2 elimination in healthy and sick lungs.
We studied the effects that the lung recruitment maneuver (RM) and positive end-expiratory pressure (PEEP) have on the elimination of CO(2) per breath (Vtco(2,br)). ⋯ CO(2) elimination by the lungs was dependent on PEEP and recruitment and showed major differences between healthy and lavaged lungs.
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Anesthesia and analgesia · Oct 2010
Comparative StudyEarly postoperative subcutaneous tissue oxygen predicts surgical site infection.
Subcutaneous oxygen partial pressure is one of several determinants of surgical site infections (SSIs). However, tissue partial pressure is difficult to measure and requires invasive techniques. We tested the hypothesis that early postoperative tissue oxygen saturation (Sto(2)) measured with near-infrared spectroscopy predicts SSI. ⋯ Sto(2) measured at the upper arm only 75 minutes after colorectal surgery predicted development of postoperative SSI, although the infections were typically diagnosed more than a week later. Although further testing is required, Sto(2) measurements may be able to predict SSI and thus allow earlier preventive measures to be implemented.