Journal of clinical anesthesia
-
Potential for assessing liver function during liver transplantation surgery by monitoring muscle paralysis from nondepolarizing neuromuscular blockers that are hepatically cleared is critically assessed. Rocuronium is strongly favored as a promising pharmacodynamic probe for predicting allograft liver function because it is predominantly eliminated via the liver and its putative metabolites are not active. ⋯ Further prospective studies are necessary with more precise measurement of neuromuscular function to confirm the predictive value of this method. Alterations in neuromuscular blocker plasma concentrations that are correlated with changes in liver function and either the dose required or the intensity or duration of paralysis needs to be demonstrated for this technique to be clinically useful.
-
Randomized Controlled Trial Comparative Study Clinical Trial
A comparative study of tracheal intubation using an intubating laryngeal mask (Fastrach) alone or together with a lightwand (Trachlight).
To determine if the Trachlight lightwand can facilitate Fastrach intubation by guiding the tip of the endotracheal tube into the trachea. ⋯ Although tracheal intubation is effective using a Fastrach alone (76% success rate), it is more effective when the Fastrach is used in conjunction with the Trachlight (95%). These results suggest that the lightwand is a useful adjunct for Fastrach intubation. However, the role of Fastrach intubation together with the Trachlight in the management of patients with a potential difficult airway remains to be determined.
-
Comparative Study
An observational evaluation of the rate of awakening after isoflurane or desflurane used in daily clinical practice.
To evaluate the rate of awakening after desflurane (D) or isoflurane (I) anesthesia when used during daily clinical practice. ⋯ Used during routine conditions, D allows for faster recovery than I in surgical procedures lasting more than 100 minutes. The rate of awakening after D remained independent of the duration of the surgical procedure.
-
Postoperative analgesia for the ambulatory surgery patient is frequently inadequate. Continuous regional analgesia improves outcome and patient satisfaction in hospitalized patients. This paper describes the successful use of continuous regional analgesia following orthopedic surgery in the ambulatory setting.
-
There is an increasing trend toward performing craniotomy for primary brain tumor excision with local anesthesia. We report the use of the laryngeal mask airway as a part of an anesthetic technique designed for patients requiring awake cortical mapping during brain tumor excision.