Journal of clinical anesthesia
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Randomized Controlled Trial
Effects of epidural anesthesia with 0.2% and 1% ropivacaine on predicted propofol concentrations and bispectral index values at three clinical end points.
To compare the effects of 0.2% epidural ropivacaine and those of 1% epidural ropivacaine on predicted propofol concentrations and bispectral index scores (BISs) at three clinical end points. ⋯ During combined epidural-propofol anesthesia, unconsciousness and lack of response to noxious stimulation occurred at lower predicted concentrations with 1% epidural ropivacaine than with 0.2% epidural ropivacaine. The results also suggest that the BIS may not be a good indicator when propofol anesthesia is combined with epidural anesthesia.
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Meta Analysis Comparative Study
Does neuraxial anesthesia reduce intraoperative blood loss? A meta-analysis.
To perform a meta-analysis of available randomized controlled trials to determine if neuraxial anesthesia would decrease blood loss, compared with general anesthesia. ⋯ Use of spinal anesthesia or EA is associated with a significant decrease in EBL when compared with that for GA or combined GA-EA.
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Randomized Controlled Trial
Dexmedetomidine infusion is associated with enhanced renal function after thoracic surgery.
To test the hypothesis that dexmedetomidine, a selective alpha-2 agonist, enhances urine flow rate and perioperative renal function, a post hoc analysis was conducted on a recently completed study of dexmedetomidine used as an adjunct to epidural analgesia after thoracotomy. ⋯ Dexmedetomidine infusion administered as a supplement to epidural analgesia induced diuresis in postthoracotomy patients with normal preoperative renal function and undergoing fluid restriction. Although this finding may represent simple reversal of a tubular antidiuresis, the lower DeltaS(Cr)% and preservation of cCl(Cr) suggest a beneficial effect on glomerular filtration compared with controls.
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Comparative Study
Transcutaneous monitoring of partial pressure of carbon dioxide in the elderly patient: a prospective, clinical comparison with end-tidal monitoring.
To evaluate the accuracy and precision of estimation of partial pressure of carbon dioxide (Pa(CO2)) using end-tidal or transcutaneous CO2 (TcP(CO2)) measurements during mechanical ventilation in the elderly patient. ⋯ Transcutaneous monitoring of CO(2) partial pressure gives a more accurate estimation of arterial CO(2) partial pressure than does Pet(CO2) monitoring.
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Randomized Controlled Trial
Postcesarean analgesia: the efficacy of bupivacaine wound instillation with and without supplemental diclofenac.
To assess the analgesic efficacy of diclofenac when administered as an adjuvant to bupivacaine wound instillation. ⋯ In the context of this study, the bupivacaine wound instillation with adjuvant diclofenac administration is associated with similar postoperative analgesia to that induced by diclofenac alone.