Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Clinical Trial
Remifentanil induces consistent and sustained controlled hypotension in children during middle ear surgery.
To determine in children whether remifentanil combined with sevoflurane, could induce controlled hypotension, reduce middle ear blood flow (MEBF) measured by laser-Doppler, and provide a satisfactory operative field. ⋯ Remifentanil combined with sevoflurane in children enabled controlled hypotension, reduced MEBF and provided good surgical conditions for middle ear surgery with no need for additional use of a specific hypotensive agent.
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Intraoperative measurement of the aortic valve (AV) gradient in patients undergoing cardiac surgery is routinely performed using transesophageal echocardiography (TEE). In patients with severe aortic stenosis (AS), TEE Doppler beam alignment with the blood flow through the stenotic valve may be inaccurate, resulting in an underestimation of the AV gradient. We describe here the use of epiaortic echocardiography as an alternative to TEE for the intraoperative evaluation of AS. ⋯ Intraoperative epiaortic measurement of AV gradients can be successfully performed in patients where TEE may be inaccurate due to difficulty in aligning a Doppler beam with the transvalvular blood flow.
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To examine the perceived urgency of 13 auditory warning alarms commonly occurring in the hospital operating room. ⋯ The alarms currently in use do not convey the intended sense of urgency to naïve listeners, and this holds even for two sets of alarms designed specifically by manufacturers to convey different levels of urgency.
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Randomized Controlled Trial Comparative Study Clinical Trial
Patient-controlled epidural analgesia reduces analgesic requirements compared to continuous epidural infusion after major abdominal surgery.
To compare the quality of pain relief and incidence of side effects between 24-hr postoperative continuous epidural infusion (CEI) and subsequent patient-controlled epidural analgesia (PCEA) with different analgesics after major abdominal surgery. ⋯ PCEA in comparison to preceding CEI provides equivalent analgesia with lower local anesthetic doses and plasma levels, and without motor blocking side effects, irrespective of the applied drug regimen.