Journal of clinical anesthesia
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Review Case Reports
Frequency of anesthetic cardiac arrest and death in the operating room at a single general hospital over a 30-year period.
To determine the anesthetic cardiac arrest (CA) and death rates in the operating room (OR) and to determine whether anesthetic CA and death are preventable. ⋯ The results of 30 years' experience do not support the hypothesis that all anesthetic CAs and deaths are preventable. However, careful clinical management can reduce their frequency to a level lower than those reported in the referenced literature.
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Randomized Controlled Trial Clinical Trial
Dexmedetomidine premedication before intravenous regional anesthesia in minor outpatient hand surgery.
To assess the efficacy and safety of intravenous (i.v.) dexmedetomidine, an alpha-2 agonist, as a premedication before i.v. regional anesthesia. ⋯ Dexmedetomidine is an effective premedication before i.v. regional anesthesia because it reduces patient anxiety, sympathoadrenal responses, and opioid analgesic requirements.
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Randomized Controlled Trial Clinical Trial
Clinical pharmacokinetics of propofol given as a constant-rate infusion and in combination with epidural blockade.
To investigate the pharmacokinetics of propofol in combination with epidural anesthesia or with intravenous (i.v.) alfentanil infusion, and to investigate the clinical feasibility of this anesthetic technique in lower abdominal surgery. ⋯ We could not show any statistically significant influence of an epidural blockade on the pharmacokinetic parameters of propofol. Nevertheless, the concentration-time profile changed during infusion, rendering the described infusion regimen, in combination with epidural anesthesia, unsatisfactory for adequate hypnosis. The propofol infusion regimen combined with alfentanil provided immediate and stable blood concentrations that were adequate for surgery.
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Randomized Controlled Trial Clinical Trial
Changes in end-tidal carbon dioxide during gynecologic laparoscopy: spontaneous versus controlled ventilation.
To study the changes in PETCO2 during spontaneous and controlled ventilation in patients undergoing gynecologic laparoscopy. ⋯ In view of the high PETCO2 levels, spontaneous breathing should be avoided during gynecologic laparoscopy, and ventilation to an initial PETCO2 of 4 kPa (30 mmHg) is recommended during controlled ventilation.
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Swedish anesthesiology is greatly indebted to the preeminent American anesthesiologist, and first professor of anesthesiology in the world, Ralph M. Waters. It was in part because of the influence and teaching of this great pioneer that modern anesthesiology became firmly established in Sweden. ⋯ Among these were four Swedes: Olle Friberg, Eric Nilsson, Karl-Gustav Dhunér, and the author. Through these Swedish pioneers and their numerous disciples, Waters had a profound influence on the development of Swedish anesthesia. The author reports his personal memories from his contact with Ralph Waters.