Anesthesia and analgesia
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Anesthesia and analgesia · Mar 2013
Comparative StudyThe TaperGuard™ endotracheal tube intracuff pressure increase is less than that of the Hi-Lo™ tube during nitrous oxide exposure: a model trachea study.
Studies have compared sealing effects of the newly developed tapered endotracheal tube cuff with the conventional cylindrical cuff. In this study, we compared the difference between cuffs with regard to the increase in intracuff pressure during nitrous oxide (N(2)O) exposure. ⋯ During general anesthesia with N(2)O, the intracuff pressure of tapered endotracheal tube cuffs did not increase as rapidly as it did in conventional high-volume, low-pressure cuffs. The pressure in both types of cuffs increased rapidly when exposed to 66% N(2)O, and hence continuous or frequent monitoring is recommended.
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Anesthesia and analgesia · Mar 2013
Randomized Controlled Trial Comparative StudyA randomized comparison of ropivacaine 0.1% and 0.2% for continuous interscalene block after shoulder surgery.
The optimal concentration of ropivacaine for continuous interscalene block after shoulder surgery is currently unknown. ⋯ These results suggest that ropivacaine 0.2% provides more effective analgesia than ropivacaine 0.1% during the first 24 hours for continuous interscalene block after shoulder surgery.
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Anesthesia and analgesia · Mar 2013
Randomized Controlled TrialDetection of tidal recruitment/overdistension in lung-healthy mechanically ventilated patients under general anesthesia.
The volume-dependent single compartment model (VDSCM) has been applied for identification of overdistension in mechanically ventilated patients with acute lung injury. In this observational study we evaluated the use of the VDSCM to identify tidal recruitment/overdistension induced by tidal volume (Vt) and positive end-expiratory pressure (PEEP) in lung-healthy anesthetized subjects. ⋯ The distension index %E(2), derived from the VDSCM considering flow-dependencies, seems able to identify tidal recruitment/overdistension induced by Vt and PEEP independent of flow waveform in healthy lung-anesthetized patients.
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Anesthesia and analgesia · Mar 2013
Randomized Controlled TrialUnwarranted variability in antibiotic prophylaxis for cesarean section delivery: a national survey of anesthesiologists.
Current guidelines from the American College of Obstetricians and Gynecologists recommend antibiotic prophylaxis for cesarean delivery immediately before incision. The purpose of this study was to measure and describe correlates of adherence to these guidelines in a sample of United States anesthesiologists. ⋯ Adherence with current prophylactic antibiotic administration guidelines for cesarean delivery is not uniform. Education initiatives, regulatory maneuvers, and process improvement should be targeted at sites where anesthesiologists do not comply with current guidelines.
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Anesthesia and analgesia · Mar 2013
Kinetics of uptake and washout of lidocaine in rat sciatic nerve in vitro.
The potency and efficacy of local anesthetics injected clinically for peripheral nerve block depends strongly on the rate of neural drug uptake. However, because diffusion into surrounding tissues and removal by the vascular system are major factors in the overall distribution of lidocaine in vivo, true kinetics of drug/neural tissue interactions must be studied in the absence of those confounding factors. ⋯ Lidocaine enters a nerve by a process other than free diffusion, through an epineurial sheath that is a slight obstacle. Given the rapid entry in vitro compared with the much smaller and transient content measured in vivo, it seems highly unlikely that lidocaine equilibrates with the nerve during a peripheral blockade.