Journal of clinical anesthesia
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Randomized Controlled Trial
Effects of mannitol in the prevention of lipid peroxidation during liver resection with hepatic vascular exclusion.
To examine the efficacy of mannitol in the prevention of lipid peroxidation during major liver resections performed during hepatic inflow occlusion. ⋯ Mannitol has an antioxidant activity, but we were unable to confirm a positive impact on the postoperative clinical course.
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To evaluate the effects of epidural, spinal, and general anesthesia on pain after lower-limb amputation. ⋯ Patients who received epidural anesthesia and those who received spinal anesthesia recalled better analgesia in the first week after their amputation than did patients who received general anesthesia. Anesthetic technique had no effect on stump pain, phantom limb sensation, or phantom limb pain at 14 months after lower-limb amputation.
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This case report describes the use of a bronchial blocker (BB) with a wheel-controlled tip (Cohen flexitip endobronchial blocker) to provide initially middle and lower right lobe isolation and then right lung isolation (RLI) during right lower lobectomy in a patient with compromised pulmonary function preoperatively. As predicted, RLI and one-lung ventilation were associated with worsening oxygenation. ⋯ The BB design made lobar isolation easier and enabled repositioning of the BB during surgery. The techniques used for BB insertion as well as lobar and lung separation are described.
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Randomized Controlled Trial
Improved postoperative analgesia with coadministration of preoperative epidural ketamine and midazolam.
To assess postoperative pain regulation and pharmacokinetic effects of preoperative administration of ketamine and midazolam. ⋯ Preoperative epidural coadministration of a low dose of ketamine with midazolam is more effective in relieving postoperative pain than using ketamine alone. In addition, epidural midazolam prolongs the elimination of ketamine.
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Comparative Study Clinical Trial
A clinical assessment of the Glidescope videolaryngoscope in nasotracheal intubation with general anesthesia.
To evaluate the efficacy and safety of the Glidescope videolaryngoscope as a device to aid nasotracheal intubation, and to determine whether the GSVL provides a better laryngeal view in patients with difficult laryngoscopy compared with the Macintosh laryngoscope. ⋯ The GSVL is an effective device for nasotracheal intubation and may be incorporated easily into routine clinical practice. Compared with the Macintosh laryngoscope, the GSVL can provide an improved laryngeal view in the patient with difficult airway.