Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Rapid sevoflurane induction compared with thiopental.
To examine whether the speed of induction of anesthesia with sevoflurane/nitrous oxide (N2O) utilizing a 10-second vital capacity rapid inhalation induction (VCRII) followed by tidal breathing was similar or faster than cautious intravenous (i.v.V) thiopental induction with inhaled N2O. ⋯ Sevoflurane/N2O VCRII as used in this investigation is an effective inhalation technique; it resulted in an induction time similar to that of slow i.v. thiopental with inhaled N2O.
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Randomized Controlled Trial Comparative Study Clinical Trial
Remifentanil used to supplement propofol does not improve quality of sedation during spontaneous respiration.
To evaluate whether the use of remifentanil to supplement propofol during spontaneous respiration confers any benefits in terms of quality of sedation and recovery, or in terms of reduction in propofol requirements. ⋯ The addition of remifentanil to propofol during spontaneous ventilation offered no benefits compared with the use of propofol alone.
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Comparative Study
Nausea and vomiting after outpatient ACL reconstruction with regional anesthesia: are lumbar plexus blocks a risk factor?
To track the incidence of in-hospital postoperative nausea and vomiting (PONV) requiring postoperative parenteral nursing interventions after outpatient reconstruction of the anterior cruciate ligament (ACL) with one of two types of regional anesthesia to determine the extent to which various anesthetic techniques, preemptive antiemetics, and other factors were associated with the lowest probability of PONV. ⋯ For ACL reconstruction with regional anesthesia, use of LUM-SCI was associated with a higher rate of PONV, whereas combination antiemetic prophylaxis with perphenazine and dexamethasone was associated with less PONV.
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Lumbar discography is a diagnostic modality to determine whether the intervertebral disc is the cause of pain. The injection of radiopaque contrast into the nucleus pulposus of the disc can reveal the internal details of the disc. We describe a case of inadvertent lumbar discogram resulting from an attempted lumbar interlaminar epidural injection at L5-S1 under fluoroscopy. ⋯ Hence, the patient did not suffer from postdural puncture headache. The needle was probably inferior to the nerve root, and no obvious nerve root trauma or irritation occurred. This potential triangle may provide alternative access for lumbar discography at the L5-S1 level.
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To determine whether postoperative "difficult airway" letters, which inform a patient that he has a difficult airway, are an effective way to communicate with patients and future caregivers. ⋯ The majority of patients who were sent a "difficult airway" letter did not obtain a MedicAlert bracelet, although frequently recommended. However, most of the patients who subsequently had surgery informed their anesthesiologist or surgeon of their airway history. "Difficult airway" letters may have significant utility even if patients do not obtain identifying jewelry.