Journal of clinical anesthesia
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To evaluate the effects of unilateral stellate ganglion blockade on left ventricular function. ⋯ In patients without cardiovascular disease, unilateral denervation of the left ventricle after stellate ganglion block produces no clinical deleterious effects on left ventricular function.
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To measure sound levels that our patients are exposed to in the surgical suite and their perception of these sound levels. ⋯ Noise prevention in the OR and recovery room needs more attention and should be a routine part of patient care.
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To determine the perioperative mortality and intraoperative morbidity according to operative procedure and postoperative period for American Society of Anesthesiologists' Physical Status (ASA-PS) V category patients. ⋯ The ASA-PS V classification is determined subjectively rather than objectively, and can be variable within its parameters, depending on the individual interpretation of ASA classification, patient population, case severity, surgical and anesthesia factors, and the year of the study. Even though immediate perioperative mortality decreased in our patient population, late postoperative mortality increased during the same time period, possibly demonstrating a shift in mortality time rather than an absolute decrease in overall mortality. Although the ASA-PS V category was never intended to be a predictor of outcome, it correlates with perioperative mortality as well as or even better than other classifications of mortality and morbidity. The decreased mortality in the ASA-PS V patient population may be related to different factors, which are beyond the scope of this study.
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Clinical Trial
Poor prediction of blood transfusion requirements in adult liver transplantations from preoperative variables.
To assess the ability of preoperative information to predict intraoperative blood transfusion requirements in adult orthotopic liver transplantation. ⋯ Preoperative variables are poor predictors of intraoperative transfusion requirements even when significant associations exist, identifying a small proportion of the variability observed. A predictive approach based on this method would be too inaccurate to be of clinical use. The majority of the variability in transfusion requirements during liver transplantation most likely results from intraoperative and donor organ factors.
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Clinical Trial
Maintaining sevoflurane anesthesia during low-flow anesthesia using a single vaporizer setting change after overpressure induction.
A sevoflurane vaporizer dial setting of 1.9% was previously found to maintain the end-expired sevoflurane concentration (Et(sevo)) at 1.3% during maintenance of anesthesia for procedures up to one hour with an O(2) FGF of 1 L/min. We examined whether applying these parameters could simplify low-flow sevoflurane anesthesia after overpressure induction using two slightly different techniques. ⋯ After high-flow overpressure induction with sevoflurane, a single change in vaporizer setting (to 1.9%) and FGF (to 1 L. min(-1)) suffices for the Et(sevo) to approach the predicted Et(sevo) (1.3%) within 10-15 min; thereafter the Et(sevo) remains nearly constant. As expected, the predicted Et(sevo) is attained slightly faster when the vaporizer is temporarily turned off. Clinically applying previously derived pharmacokinetic parameters simplifies low-flow sevoflurane anesthesia after overpressure induction.