Journal of clinical anesthesia
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Randomized Controlled Trial Clinical Trial
Active warming, not passive heat retention, maintains normothermia during combined epidural-general anesthesia for hip and knee arthroplasty.
to compare passive heat retention by low-flow anesthesia, alone and with additional thermal insulation by reflective blankets, with forced-air warming preventing intraoperative hypothermia during combined epidural-general anesthesia. ⋯ During combined epidural-general anesthesia for elective hip and knee arthroplasty, passive heat retention by means of low-flow anesthesia alone and in combination with reflective blankets is ineffective in maintaining intraoperative normothermia and definitely inferior to active forced-air warning.
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Anesthesia often involves the administration of several drugs belonging to different classes. In addition, many patients will be taking a number of drugs related to their surgical condition or for other medical diseases. ⋯ Other important interactions involve monoamine oxidase inhibitors, some antibiotics, and the tricyclic and tetracyclic antidepressants. These adverse interactions are the subject of this review.
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Catheters used to facilitate extubations of the known difficult airway are usually placed through an existing endotracheal tube (ETT), prior to its removal. We present a case in which a #11 Cook airway exchange catheter was placed adjacent to the ETT and left intratracheal for an extended period following removal of the ETT.
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To identify variables influencing the likelihood of unanticipated admission following scheduled ambulatory surgery. ⋯ Surgery duration of 60 minutes or longer was the most important predictor of unanticipated admission following scheduled ambulatory surgery.
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The intraoperative monitoring of neuromuscular blockade usually involves measurement of the muscular responses to motor nerve stimulation. Although researchers have the time and technology to obtain predrug control measurements of the twitch responses, these are seldom available to the clinician. ⋯ Concentrations in the effect compartment associated with these two extremes of the TOF count are combined with concentration-time profiles of vecuronium with various dose regimens. This study models the effect compartment concentrations associated with vecuronium-induced paralysis, combining them explicitly with the range of concentrations associated with the TOF count to demonstrate the kinetic mechanisms underlying the time-course of paralysis.