Journal of clinical anesthesia
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Randomized Controlled Trial
Does clonidine 50 microg improve cervical plexus block obtained with ropivacaine 150 mg for carotid endarterectomy? A randomized, double-blinded study.
To evaluate the effects of adding 50 microg clonidine to 150 mg ropivacaine for superficial cervical plexus block in patients undergoing elective carotid endarterectomy (TEA). ⋯ Adding 50 microg clonidine to 150 mg ropivacaine for superficial cervical plexus block shortened the onset time and improved the quality of surgical anesthesia in patients undergoing elective TEA.
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To examine, with a large database, the effect of postoperative epidural analgesia (vs systemic analgesia) on mortality after colectomy is unclear. ⋯ The presence of postoperative epidural analgesia may decrease the odds of death after elective colectomy; however, the mechanism of such a benefit is not clear from our analysis.
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Placement of double-lumen endobronchial tubes (DLTs) into the trachea can be difficult because of their size and configuration. For patients with abnormal airway anatomy and anticipated difficult tracheal intubation, DLT placement can be extremely challenging. We present our experience using lighted stylets to facilitate insertion of DLTs in a series of patients with difficult airway anatomy.
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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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To evaluate the efficacy of nerve stimulation as an adjunct to ultrasound-guided supraclavicular nerve blocks. ⋯ For adequately imaged ultrasound-guided supraclavicular nerve blocks, a positive motor response to nerve stimulation does not increase the success rate of the block. In addition, the high false-negative rate suggests that these blocks are usually effective, even in the absence of a motor response. Nerve stimulation as an adjunct to ultrasound guidance may have a limited role.