Journal of clinical anesthesia
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Randomized Controlled Trial
Effects of intraoperative high-dose vs low-dose remifentanil for postoperative epidural analgesia after gynecological abdominal surgery: a randomized clinical trial.
To evaluate whether intraoperative high-dose remifentanil infusion increased local anesthetic consumption in postoperative epidural analgesia and postoperative pain scores compared with low-dose remifentanil infusion. ⋯ Intraoperative high-dose remifentanil infusion increased local anesthetic consumption in postoperative epidural analgesia relative to low-dose remifentanil.
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Comparative Study
Comparison of the diameter, cross-sectional area, and position of the left and right internal jugular vein and carotid artery in adults using ultrasound.
Central venous access is indicated for transduction of central venous pressure and the administration of inotropes in the perioperative period. The right internal jugular vein (RIJV) is cannulated preferentially over the left internal jugular vein (LIJV). Cannulation of the LIJV is associated with a higher complication rate and a perceived increased level of difficulty when compared with cannulation of the RIJV. Possible explanations for the higher complication rate include a smaller diameter and more anterior position relative to the corresponding carotid artery (CA) of the LIJV compared with the RIJV. In this study, the RIJV and LIJV were examined in mechanically ventilated patients to determine the validity of these possible explanations. ⋯ This study confirms the smaller diameter and increased frequency of anterior positioning relative to the corresponding CA of the LIJV when compared with the RIJV. This validates them as possible explanations for the higher complication rate of LIJV cannulation compared with RIJV cannulation.
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Randomized Controlled Trial
Inspection of the nasopharynx prior to fiberoptic-guided nasotracheal intubation reduces the risk epistaxis.
Various complications may occur during nasotracheal intubation. This may include epistaxis and damage to the nasopharyngeal airway. We tested the hypothesis that the use of fiberoptic bronchoscopy (FOB)-guided intubation is superior to endotracheal tube (ETT) obturated with an inflated esophageal stethoscope. ⋯ Fiberoptic-guided nasotracheal intubation was associated with less epistaxis. It also showed better navigability and less redirection rate. Therefore, FOB as an intubation guide is superior to ETT with an inflated esophageal stethoscope when intubating a patient via the nasotracheal route.
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Comparative Study
Respiratory variation of systolic and diastolic time intervals within radial arterial waveform: a comparison with dynamic preload index.
A blood pressure (BP) waveform contains various pieces of information related to respiratory variation. Systolic time interval (STI) reflects myocardial performance, and diastolic time interval (DTI) represents diastolic filling. This study examined whether respiratory variations of STI and DTI within radial arterial waveform are comparable to dynamic indices. ⋯ Respiratory variations of STI and DTI derived from radial arterial contour have a potential to predict hemodynamic response as a surrogate for SVV or PPV.