Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of the effects of propofol and midazolam on the cardiovascular autonomic nervous system during combined spinal and epidural anesthesia.
To investigate the effect of propofol and midazolam on cardiac autonomic nervous system (CANS) activity during combined spinal-epidural anesthesia. ⋯ Propofol was more potent than midazolam in causing CANS activity to be sympatholytic during combined spinal and epidural anesthesia and which was correlated with age only with propofol.
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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.