Journal of clinical anesthesia
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To ascertain patients' recall of the risks of labor epidural analgesia from a discussion of informed consent during active labor. ⋯ Recall of risks by parturients is similar to the recall of risks by other patients, and it does not appear to be affected by parity or the reported level of pain.
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To evaluate the onset of spinal anesthesia with power spectral heart rate analysis to determine the influence of the block on the autonomic nervous system. ⋯ Power spectral heart rate analysis during low thoracic bupivacaine spinal anesthesia is compatible with decreased sympathetic activity during stable hemodynamic intervals. Insertion of hip endoprosthesis resulted in a dramatic, transient increase in sympathetic activity, indicating that sympathetic activation was still possible despite the presence of surgical anesthesia from the subarachnoid block.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Oral dolasetron mesylate for prevention of postoperative nausea and vomiting: a multicenter, double-blind, placebo-controlled study. The Oral Dolasetron PONV Prevention Study Group.
To examine the safety and effectiveness of a range of single oral doses of dolasetron mesylate for the prevention of postoperative nausea and vomiting. ⋯ Single oral doses of dolasetron, administered 1 to 2 hours before induction of anesthesia, are safe and effective for preventing postoperative nausea and vomiting in this patient sample. Maximal antiemetic response was seen with the 50 mg oral dolasetron dose.
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Randomized Controlled Trial Clinical Trial
Altered reactivity to acetylcholine in the pulmonary circulation after cardiopulmonary bypass is part of reperfusion injury.
To investigate whether a time sequence of acetylcholine (ACH) reactivity indicative of endothelial reperfusion injury could be demonstrated in the pulmonary circulation in patients after cardiopulmonary bypass (CPB). ⋯ The maintained reactivity to ACH directly after CPB, followed by no reaction at 1 to 1.5 and 4 hours, was in agreement with experimental findings and indicates endothelial reperfusion injury caused by the period with no blood flow through the pulmonary artery during CPB and subsequent reperfusion.
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To determine the utility of cerebral oximetry for monitoring the adequacy of cerebral blood flow (CBF) during carotid cross-clamp. ⋯ Cerebral SaO2 decreased significantly on carotid cross-clamp in patients undergoing awake CEA. Hemodynamically stable patients demonstrated no evidence of regional brain failure when SaO2 decreased to 63% (mean decrease of 7.2%). Two hemodynamically unstable patients had evidence of global brain failure when SaO2 was less than 48% (mean decrease of 36%). Our findings suggest that cerebral oximetry reflects CBF, and it may be an effective, noninvasive method of monitoring regional cerebral oxygenation changes during CEA. Significant reductions in regional SaO2 may be tolerated without evidence of brain failure. Further studies are needed to define an SaO2 threshold that reflects regional brain failure.