Journal of clinical anesthesia
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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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Biography Historical Article
Davy comes to America: Woodhouse, Barton, and the nitrous oxide crossing.
In the final decade of the eighteenth century, a new method of medical treatment appeared in England when physician Thomas Beddoes developed a systematic application of Joseph Priestley's "factitious airs", or gases, to treat consumptive patients. Supported by peers such as Erasmus Darwin and using applications designed for him by James Watt and other inventors, Beddoes combined technological innovation and gas inhalation in an attempt to cure his patients. Late in the decade Beddoes hired young Humphry Davy as his assistant; Davy quickly added nitrous oxide to the armamentarium. ⋯ Such intermittent experimentation continued in the United States and Europe until Horace Well's public demonstration of ether inhalation in January 1845. This paper describes how nitrous oxide inhalation survived in America through the work of Woodhouse and Wells. Traveling showmen like Samuel Colt and Gardner Quincy Colton demonstrated the gas' effects at popular lectures.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Comparative Study Clinical Trial
Desflurane controls the hemodynamic response to surgical stimulation more rapidly than isoflurane.
To compare the control of hemodynamic response to surgical stimulus of desflurane to that of isoflurane. ⋯ Anesthetic depth can be more rapidly titrated with desflurane compared to isoflurane. Alveolar/inspired concentration ratio approaches unity more rapidly with desflurane anesthesia.
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Cardiopulmonary bypass (CPB) does not appear to cause excessive maternal risk, but the potential for fetal complications is of great concern. In general, operative intervention should be delayed until at least the second trimester. ⋯ This conflict is further complicated by maternal status changes that may accompany valvular disease or develop after CPB. The case described herein summarizes and discusses these conflicts.
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The successful management of major conduction anesthesia in a patient with Klippel-Trenaunay syndrome is discussed. This case illustrates that major conduction anesthesia can be safely used if proper imaging studies are obtained, if one is aware of the underlying disease process, and if there is no port wine lesion in the dermatomal area corresponding to the spinal segment where the needle is to be inserted.