Journal of clinical anesthesia
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Randomized Controlled Trial
The ideal oxygen/nitrous oxide fresh gas flow sequence with the Anesthesia Delivery Unit machine.
To determine whether early reduction of oxygen and nitrous oxide fresh gas flow from 6 L/min to 0.7 L/min could be accomplished while maintaining end-expired nitrous oxide concentration > or =50% with an Anesthesia Delivery Unit anesthesia machine. ⋯ A 3-minute high-flow period (oxygen and nitrous oxide fresh gas flow of 2 and 4 L/min, respectively) suffices to attain and maintain end-expired nitrous oxide concentration > or =50% and ensures an adequate bellows volume during the ensuing low-flow period.
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Randomized Controlled Trial Comparative Study
Opioid consumption in total intravenous anesthesia is reduced with dexmedetomidine: a comparative study with remifentanil in gynecologic videolaparoscopic surgery.
To evaluate the capacity of dexmedetomidine (DEX), an alpha(2) adrenergic agonist drug, as a substitute for remifentanil (REM), a potent opioid, in total intravenous anesthesia (TIVA), in patient undergoing gynecologic videolaparoscopy. ⋯ Dexmedetomidine was a clinically effective drug as a REM substitute in TIVA, during minimally invasive video gynecologic surgical procedures; however, patients anesthetized with DEX showed a more prolonged recovery time for some parameters such as orientation and extubation times.
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Randomized Controlled Trial Comparative Study
Comparison of hemodynamic responses to orotracheal intubation with the GlideScope videolaryngoscope and the Macintosh direct laryngoscope.
To identify the hemodynamic responses to orotracheal intubation using a GlideScope videolaryngoscope (GSVL) in healthy adults, and to determine whether the GSVL could attenuate the hemodynamic response to orotracheal intubation compared with the Macintosh direct laryngoscope (MDLS). ⋯ The hemodynamic responses to orotracheal intubation using a GSVL and an MDLS were similar. The GSVL had no any special advantage over the MDLS in attenuating the hemodynamic responses to orotracheal intubation.
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Randomized Controlled Trial
The analgesic efficacy of continuous elastomeric pump ropivacaine wound instillation after appendectomy.
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Trauma to epidural catheters on insertion or removal may result in shearing or breakage. Although there is no evidence of neurologic sequelae from a sheared catheter, many reports still advocate eventual surgical removal. The literature suggests the following options: (1) using slow continuous force at all times; (2) discontinuing application of force if the catheter begins to stretch and reapplying traction several hours later; (3) placing of the patient in the same position as insertion; (4) placing the patient in the lateral decubitus position if possible; (5) attempting to remove in extreme flexion if the previous interventions are not efficacious; (6) attempting extension if flexion fails; (7) attempting removal after injection of preservative-free normal saline through the catheter; (8) considering use of a convex surgical frame; (9) considering computed tomographic scan to identify the etiology of entrapment; (10) considering leaving a retained epidural catheter in place in adult patients; (11) providing patient education regarding "red flags" to watch out for; and (12) neurosurgical consultation for all cases in which the catheter fragment is in the spinal canal.