Journal of clinical anesthesia
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Randomized Controlled Trial Clinical Trial
Effects of nilvadipine on the cardiovascular responses to tracheal intubation.
To evaluate the efficacy of nilvadipine given orally in attenuating the hypertensive response to laryngoscopy and intubation. ⋯ Oral administration of nilvadipine before induction of anesthesia is a simple and practical method for attenuating pressor response to laryngoscopy and tracheal intubation after standard elective induction under additional 1% enflurane-N2O anesthesia.
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Randomized Controlled Trial Clinical Trial
Lidocaine blood levels following aerosolization and intravenous administration.
To determine whether, following aerosolization of lidocaine for topical airway anesthesia, intravenous (IV) lidocaine produces toxic lidocaine blood concentrations. ⋯ IV lidocaine can be safely administered following aerosolization of lidocaine in spontaneously breathing patients without producing toxic blood lidocaine concentrations.
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To evaluate the clinical use of a cardiorespiratory rate monitor in patients receiving epidural opioids following major surgery. ⋯ The cardiorespiratory rate monitor is useful in patients at risk for bradypnea following surgery.
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To investigate the effects of different clinical induction techniques on heart rate variability (HRV). ⋯ In Study 1, the greater reduction in HRV with the thiopental sodium technique provides evidence that the depressant effects of anesthetics on HRV are related in part to their effects on cardiovascular reflexes. However, the significant depression in HRV caused by the etomidate technique suggests that mechanisms other than baroreflex depression (e.g., impaired consciousness) also are important in these depressant effects. In Study 2, the decrease in HRVHI caused by sufentanil documents that absolute power measurements of vagally mediated HRV are not correlated with changes in parasympathetic tone during a potent opioid induction. This lack of a correlation may result from the decrease in total HRV observed with loss of consciousness. The increase in %HRVHI suggests that normalized measurements of HRV may still provide an index of changes in sympathetic-parasympathetic balance, even when total HRV is decreased following anesthetic administration.