Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Randomized comparison of isoflurane and sevoflurane for laparoscopic gastric banding in morbidly obese patients.
To compare the efficacy and recovery profile of sevoflurane and isoflurane as the main anesthetics for morbidly obese patients. ⋯ Sevoflurane provides a safe and effective intraoperative control of cardiovascular homeostasis in morbidly obese patients undergoing laparoscopic gastric banding, with the advantage of a faster recovery and earlier discharge from the postanesthesia care unit than isoflurane.
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Randomized Controlled Trial Clinical Trial
The effect of transdermal nitroglycerin on spinal S(+)-ketamine antinociception following orthopedic surgery.
To determine whether combination of transdermal nitroglycerine (a nitric oxide generator) would enhance analgesia from epidural S(+)-ketamine (a N-methyl-D-aspartate antagonist) in patients undergoing orthopedic surgery with combined spinal anesthesia. ⋯ Epidural S(+)-ketamine resulted in antinociception, which was enhanced by transdermal nitroglycerin.
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Randomized Controlled Trial Clinical Trial
Transcutaneous electrical nerve stimulation does not augment epidural labor analgesia.
To evaluate whether transcutaneous electrical nerve stimulation (TENS) can increase the quality and duration of an initiation dose of bupivacaine used for the establishment of epidural labor analgesia. ⋯ In healthy laboring parturients, the application of a TENS unit did not alter the quality or duration of an initiation dose of bupivacaine utilized for the establishment of epidural labor analgesia.
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Randomized Controlled Trial Clinical Trial
Ketamine, not propofol, attenuates cerebrovascular response to carbon dioxide in humans with isoflurane anesthesia.
To investigate the effects of ketamine and propofol on the cerebrovascular response to carbon dioxide (CO(2)) in humans during isoflurane anesthesia. ⋯ In humans given isoflurane anesthesia, a) ketamine reduced cerebrovascular response to CO(2), but cerebral blood flow (CBF) during hypercapnic conditions was comparable with controls, and b) although propofol decreases CBF, it maintains the cerebrovascular response to CO(2).
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To assess the utility of troponin I, the only molecular marker of myocardial injury not expressed in regenerating muscle, in diagnosing perioperative myocardial infarction (MI) in the setting of orthopedic surgery where false elevations in creatine kinase MB isoenzymes (CKMB) are known to occur. ⋯ Troponin I is as sensitive a marker of MI as CKMB in the orthopedic population, but it has a higher specificity in the perioperative setting. Troponin I can be helpful in properly identifying the source of CKMB elevation postoperatively when this elevation is questionable.