Journal of clinical anesthesia
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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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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 Comparative Study Clinical Trial
Transarterial brachial plexus anesthesia for hand surgery: a retrospective analysis of 346 cases.
To study the safety and efficacy of the transarterial approach to brachial plexus block with 60 to 70 ml of local anesthetic solution, and to compare the success and complication rates of this block performed by experienced or inexperienced anesthesiologists. ⋯ Transarterial brachial plexus block administered with a 60 to 70 ml dose of local anesthetic provides surgical analgesia for hand surgery with an excellent success rate and without serious adverse effects.
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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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To determine the frequency of true and false alarms and to determine the frequency of alarm failures for various parameters when using a postanesthesia monitoring system. ⋯ The high frequency of apnea strongly motivates the use of continuous RR monitoring, preferably by flow-sensing techniques, since both central and obstructive apneas are then detected. Further study and development is necessary before pulse oximetry can be unconditionally recommended for postanesthesia monitoring.