Journal of clinical anesthesia
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To investigate the effect of intravenous (IV) phenylephrine (PHE) bolus administration on left ventricular function in patients who developed postural hypotension during isoflurane anesthesia in the head-up tilt (reverse Trendelenburg) position. ⋯ PHE bolus administration effectively restored BP and cardiac filling, which were reduced after head-up tilt, without causing a relevant impairment of left ventricular function or an increase in end-systolic wall stress above the upper normal limit.
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To determine (1) the general risk and outcome in the recovery room among 4 different anesthetic techniques associated with 2 different extracorporeal shock wave lithotripsy (ESWL) machines and (2) any gender-related differences among patients undergoing ESWL. ⋯ (1) Overall, ESWL is relatively safe. Both machine types and all anesthetic techniques exhibited a low risk and good outcome. (2) There appear to be gender-related differences during ESWL. Female and male patients may have different pain and nausea and/or vomiting thresholds during ESWL.
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Randomized Controlled Trial Clinical Trial
Midazolam pretreatment does not ameliorate myoglobinemia or the clinical side effects of succinylcholine.
To determine whether the levels of serum myoglobin and the occurrence of fasciculations and postoperative symptoms following a single dose of succinylcholine are modified by the prior administration of midazolam. ⋯ Midazolam had no effect on myoglobin level or postoperative symptoms following succinylcholine.
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To estimate the sensitivity and specificity of somatosensory evoked potentials (SSEPs) for predicting new postoperative motor neurologic deficits during intramedullary spinal cord surgery; to establish whether SSEPs more accurately predicted postoperative deficits in position and vibration sense than in strength. ⋯ Intraoperative SSEP changes during intramedullary spinal cord surgery are a sensitive predictor of new postoperative motor deficits, but such changes may not correlate reliably with postoperative deficits in position or vibration sense. In this setting SSEP monitoring serves primarily to reassure the operating team that, when the SSEPs remain constant, the surgery has not caused additional injury.
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Case Reports
The BAAM and endotrol endotracheal tube for blind oral intubation. Beck Airway Air Flow Monitor.
Blind oral intubation in a spontaneously breathing patient can be facilitated with a combination of two devices used mainly for nasotracheal intubation, the BAAM (Beck Airway Air Flow Monitor, Great Plains Ballistics, Lubbock, TX) and the Endotrol endotracheal tube (Mallinckrodt Critical Care, Inc., St. Louis, MO). ⋯ In the successful approach we describe, the tube was passed through the oral cavity and pharynx in a blind fashion, using the BAAM's whistling sound for guidance and the plastic ring of the Endotrol tube to help positioning. This equipment combination may be useful in certain difficult intubation situations.