Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of general anesthesia with and without lumbar epidural for total hip arthroplasty: effects of epidural block on hip arthroplasty.
To determine whether lumbar epidural anesthesia, when combined with general anesthesia, decreases perioperative blood loss, the incidence of postoperative deep vein thrombosis (DVT), cardiac dysrhythmias, and ischemia in patients undergoing total hip arthroplasty (THA). ⋯ Combined regional-general anesthesia decreases intraoperative blood loss in THA, and thereby offers an advantage over general anesthesia alone.
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Randomized Controlled Trial Comparative Study Clinical Trial
Postthyroidectomy analgesia: morphine, buprenorphine, or bupivacaine?
To compare three analgesic regimens for pain relief after thyroidectomy. ⋯ The administration of sublingual buprenorphine after thyroidectomy provides better analgesia than small doses of oral controlled-release morphine or than 0.25% bupivacaine wound infiltration at the end of surgery.
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Venous air embolism (VAE) can be a lethal complication of surgical procedures, during which (1) venous pressure at the site of surgery is subatmospheric or (2) gas is forced under pressure into a body cavity. Though classically associated with neurosurgery, VAE is also a potential complication of laparoscopic, pelvic, and orthopedic procedures. It is, therefore, essential for the practicing anesthesiologist to recognize and treat venous air entrainment. An in-depth review of the pathophysiology, clinical presentation, detection, prevention, and treatment of VAE is presented.
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To determine the volume of air in 1000-ml crystalloid bags before and after connection to an infusion set; and to determine the volume of air that is not eliminated by the air eliminator in the Level 1 fluid warming device (Level 1 Technologies, Inc., Rockland, MA) when air boluses of different volumes enter into the fluid warming set. ⋯ Air must be rigorously eliminated from all fluid containers because of the limited air elimination capability of the Level 1 air eliminator.
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Comparative Study
Effects of gas flow management on postintubation end-tidal anesthetic concentration and operating room pollution.
To study how different anesthetic practices during the transition from anesthetic delivery by mask to endotracheal intubation affect end-tidal postintubation anesthetic concentration and operating room (OR) pollution. ⋯ In a mechanical model of anesthetic induction, turning the gas flows off before "intubation" and leaving the vaporizer on (the gas off practice) maintained "postintubation" end-tidal drug concentrations close to "preintubation" equilibrium and minimized OR pollution.