Canadian journal of anaesthesia = Journal canadien d'anesthésie
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The vascular response to anesthetics is altered in hypertensive patients since the functional and structural integrities of vascular smooth muscle and endothelium are deranged. The effects of anesthetics on angiotensin II (Ang II)-induced changes in vascular tone are not well understood. We investigated the effects of sevoflurane and isoflurane on Ang II-induced vasoconstriction in spontaneously hypertensive rats (SHR). ⋯ Our finding that the inhibitory effects of isoflurane and sevoflurane on Ang II-induced vasoconstriction are enhanced in SHR may, at least in part, account for the anesthesia-induced systemic hypotension frequently seen in hypertensive patients.
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Randomized Controlled Trial Clinical Trial
Aprotinin decreases the incidence of cognitive deficit following CABG and cardiopulmonary bypass: a pilot randomized controlled study.
Cognitive deficit after coronary artery bypass surgery (CABG) has a high prevalence and is persistent. Meta-analysis of clinical trials demonstrates a decreased incidence of stroke after CABG when aprotinin is administrated perioperatively. We hypothesized that aprotinin administration would decrease the incidence of cognitive deficit after CABG. ⋯ In this prospective pilot study, the incidence of cognitive deficit after CABG and cardiopulmonary bypass is decreased by the administration of high-dose aprotinin.
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Randomized Controlled Trial Comparative Study Clinical Trial
The Microcuff tube allows a longer time interval until unsafe cuff pressures are reached in children.
To compare cuff pressures during nitrous oxide exposure in the new Microcuff pediatric tracheal tube (MPT) with ultrathin high volume - low pressure polyurethane cuff to a tube with a standard polyvinyl chloride (PVC) cuff. ⋯ When baseline inflation pressure was set at 20 cm H(2)O, cuff pressure increased similarly in MPT and PVC tubes. When inflated just to sealing pressure, the MPT allowed a longer time interval until the upper limit of 25 cm H(2)O was reached.
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We have evaluated randomized controlled trials of the administration of clonidine, neostigmine, steroids and non-steroidal anti-inflammatory agents intra-articularly as adjuvants to local anesthetic drugs after arthroscopic knee surgery. ⋯ Current evidence indicates that a variety of agents have synergistic effects when added to local anesthetics and there is evidence that the improvement in analgesia is, at least partially, through a local rather than a central mechanism. The results of this review suggest that clonidine and ketorolac, when administered intra-articulary after arthroscopic knee surgery, may reduce postoperative pain.
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Randomized Controlled Trial Clinical Trial
Preemptive gabapentin decreases postoperative pain after lumbar discoidectomy.
We investigated whether the preemptive use of gabapentin, a structural analogue of gamma amino butyric acid could reduce postoperative pain and fentanyl consumption in patients after single-level lumbar discoidectomy. ⋯ Preemptive gabapentin 300 mg po significantly decreases the severity of pain postoperatively in patients who undergo single-level lumbar discoidectomy.