Journal of clinical anesthesia
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Randomized Controlled Trial Clinical Trial
Effects of atrial natriuretic peptide at a low dose on water and electrolyte metabolism during general anesthesia.
To assess the hemodynamic, renal, and endocrine effects of small continuous doses of atrial natriuretic peptide (ANP) in patients anesthetized with sevoflurane for gastrectomy. ⋯ Continuous intravenous infusion of ANP at 0.05 microg/kg/min during gastrectomy was associated with greater water and electrolyte excretion unaccompanied by changes in potentially interacting hormones. Low-dose infusion may be particularly safe and useful for controlling water and electrolyte metabolism intraoperatively.
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Randomized Controlled Trial Clinical Trial
Constant positive airway pressure reduces hypoventilation induced by inhalation anesthesia.
To discover if reducing respiratory system impedance would increase tidal volume and improve ventilation during inhalation anesthesia. ⋯ We conclude that constant positive airway pressure titrated to optimal respiratory system compliance will increase efficiency of inspiratory muscles and improve ventilation. Constant positive airway pressure facilitates a pattern of breathing that minimizes some of the adverse pulmonary effects of inhalation anesthesia.
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The purpose of this study is to determine whether routine preoperative testing has a usefulness not previously recognized in a small preliminary study to decide if such a hypothesis might be worthy of testing in a larger study. ⋯ Although the incidence of unindicated preoperative screening tests is still more than 50%, no previously unidentified benefit was found to support this persistence of unwarranted testing. The limited number of patients in this study necessitates a larger study to ensure greater certainty before such a recommendation is made to the public. If similar results in another but larger study involving similar design, simple changes in the system of preoperative care may save the health care system the considerable expense of unwarranted testing.
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To measure resistance of the Combitube, a supraglottic ventilatory device used in the management of the patients with difficult airways, and its influence on delivered ventilatory pressures. ⋯ The Combitube has significant airflow resistance that should be considered when patients are mechanically ventilated because the delivered oropharyngeal pressure is significantly lower than the pressure measured at the anesthesia breathing system.
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To determine the postoperative outcome of narcolepsy patients, a population that may be at increased risk of perioperative complications, including postoperative hypersomnia, prolonged emergence after general anesthesia, and apnea. ⋯ Pharmacological therapy for narcolepsy should be continued during the perioperative period. In addition, treated narcolepsy patients are at no increased risk for postoperative complications.