Journal of clinical anesthesia
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Randomized Controlled Trial
The effect of epidural lidocaine administration on sedation of propofol general anesthesia: a randomized trial.
To examine the influence of epidural and intravenous (IV) lidocaine, and height of the epidural sensory block, on the dose of propofol required for induction of general anesthesia. ⋯ Epidural and IV lidocaine reduce the dose of propofol required to induce general anesthesia. Administration of lidocaine via the epidural route reduces anesthetic requirements more so than the IV route. Propofol requirements were further reduced in patients with higher sensory epidural block.
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To ascertain current knowledge, attitudes, and practices of anesthesiology residents regarding tobacco control, and to determine the characteristics of current residency training offered in tobacco control. ⋯ A need exists for expanded formal education on perioperative tobacco cessation interventions for anesthesiology residents.
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Comparative Study Observational Study
Superior laryngeal nerve block: an anatomical study comparing two techniques.
To determine whether an anterior approach is as successful as the conventional posterior approach to superior laryngeal nerve block. ⋯ There was no significant difference in success in staining the superior laryngeal nerve in human cadavers between the conventional posterior approach and an anterior approach.
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To determine the association between one anesthetic exposure and behavioral outcome at age 10 to 12 years. ⋯ The incidence of behavioral abnormalities increased when anesthesia and surgery were accompanied by younger age, longer duration of surgery, and use of multiple anesthetic agents.
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A patient with a drug-eluting stent placed 18 months earlier received a thoracic epidural for perioperative analgesic control as part of her thoracotomy. Postoperatively, the patient was started on clopidogrel for secondary prevention. ⋯ The patient then underwent hourly neurologic checks for 24 hours and was discharged several days later without any negative sequelae. If neuraxial techniques and the need for clopidogrel prophylaxis come into direct conflict, vigilance is necessary for warning signs of epidural hematoma and platelet transfusion should be considered to reverse the effects of the drug.