Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Propofol-based anesthesia as compared with standard anesthetic techniques for middle ear surgery.
To determine if a total intravenous (i.v.) technique with propofol and fentanyl is superior to isoflurane anesthesia in patients undergoing middle ear surgery. ⋯ Propofol-fentanyl seems to be a better anesthetic than isoflurane-fentanyl in reducing the incidence of nausea and vomiting after middle ear surgery. Through the addition of droperidol to the isoflurane anesthetic seemed as effective, emergence from anesthesia was slower. For middle ear surgeries producing emesis, propofol-based anesthetics produced a rapid emergence with less nausea and vomiting.
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Randomized Controlled Trial Clinical Trial
Cardiovascular reflexes during anesthesia induction and tracheal intubation in elderly patients: the influence of thoracic epidural anesthesia.
To determine whether thoracic epidural anesthesia performed prior to general anesthesia provides hemodynamic protection from the stress of laryngoscopy and tracheal intubation; to access the autonomic reflex response to epidural anesthesia, general anesthesia, and airway stimulation. ⋯ Thoracic epidural blockade combined with general anesthesia was associated with preserved baroreflex function, and it afforded hemodynamic protection during laryngoscopy and tracheal intubation.
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Meta Analysis
The incidence of aspiration associated with the laryngeal mask airway: a meta-analysis of published literature.
To determine the incidence of pulmonary aspiration with the laryngeal mask airway (LMA). ⋯ The evidence to date suggests that the pulmonary aspiration with the LMA is uncommon and comparable to that for outpatient anesthesia with the face mask and tracheal tube. Meticulous attention to selection of low-risk patients and appropriate operative procedures and avoidance of light anesthesia should reduce the incidence even further.
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Hyskon, a distension medium composed of dextran 70 in 10% dextrose in water, is often used during hysteroscopic procedures. Coagulopathy and pulmonary edema are the most commonly reported side effects encountered during its use. We present the first case report in which a healthy patient developed pulmonary hemorrhage from Hyskon use. The major side effects of Hyskon are discussed, as are the possible etiologies of the reported complication and the implications for anesthesiologists.