Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of cardiovascular responses to airway management: fiberoptic intubation using a new adapter, laryngeal mask insertion, or conventional laryngoscopic intubation.
To evaluate the circulatory effects of fiberoptic intubation with a newly developed mask adapter and to compare these effects with those obtained with a conventional laryngoscope and laryngeal mask airway with general anesthesia. ⋯ Fiberoptic intubation with general anesthesia using the newly developed mask adapter offers an advantage over the standard laryngoscope for patients in whom pressor response of intubation is potentially hazardous.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of intravenous ketorolac and alfentanil as supplements to propofol anesthesia for diagnostic panendoscopy.
To determine if ketorolac tromethamine is an acceptable alternative to alfentanil as a supplement to propofol for diagnostic panendoscopy. ⋯ Supplementation of propofol anesthesia with ketorolac is an efficacious alternative to supplementation with alfentanil. The faster recovery in the ketorolac group is explained by the mostly peripheral effect of this drug, whereas the slow decline in the alfentanil concentration at the effective site may be responsible for slower emergence from anesthesia.
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Randomized Controlled Trial Clinical Trial
Nebulized bupivacaine attenuates the heart rate response following tracheal intubation.
To determine whether nebulized bupivacaine attenuates the acute hemodynamic response to laryngoscopy and intubation. ⋯ Nebulized 0.75% bupivacaine was only partially effective in blunting the hemodynamic response to tracheal intubation.
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Recent case reports suggest there may be an increased risk of abnormally high blockade ("high spinal") from subarachnoid anesthesia if it is performed immediately after epidural anesthesia. We describe two cases of high spinal anesthesia following failed epidural block in obstetric patients scheduled for cesarean delivery. Using a retrospective chart review, we estimate the incidence of high spinal anesthesia to be 11% in patients after prior failed epidural blockade versus fewer than 1% in patients undergoing spinal anesthesia alone.
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Continuous infusion of intravenous (i.v.) drugs is increasing in popularity, as technological advances in equipment (such as "smart" pumps) and pharmacologic improvements of drugs (such as ultra-short acting drugs) are introduced into clinical anesthesia practice. Such new technology, however, also introduces potential new complications. We report one such complication associated with the improper manufacturing of a proprietary i.v. tubing and cassette system.