Journal of clinical anesthesia
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Randomized Controlled Trial
The analgesic efficacy of continuous elastomeric pump ropivacaine wound instillation after appendectomy.
To evaluate the analgesic efficacy and safety of ropivacaine 0.2% when administered continuously via elastomeric pump after appendectomy. ⋯ Wound instillation with ropivacaine 0.2% is a useful, practical, and safe method for management of postoperative pain after appendectomy.
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To determine--through reconstruction of a clinical situation in which a syringe filled with insulin was removed from the syringe pump, placed above the patient, then emptied into the patient--the different physical forces at work, and to examine the height of the syringe (and thus the hydrostatic force) necessary to move the plunger. ⋯ Studies testing the effect of siphoning using one syringe cannot be interpreted reliably. Smaller syringes are safer to avoid siphoning.
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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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The prone position impairs the ability for endotracheal intubation by direct laryngoscopy. We describe the airway management of a 25-year-old woman with an extensive open wound over her back and fractured pelvis. She was treated in the prone position and was scheduled for debridement of her wound with skin grafting during general anesthesia. Her trachea was successfully intubated on the first attempt using an intubating Laryngeal Mask Airway while she was in the prone position.