Journal of clinical anesthesia
-
Observational Study
Frequency of inadequate neuromuscular blockade during general anesthesia.
We used electronic health record data to define frequency of inadequate intraoperative neuromuscular blockade (NMB). ⋯ Nearly 1% of all general anesthetic procedures involving NMB exhibit inadequate relaxation resulting in procedural interruption. These data suggest that current use of neuromuscular blocking drugs and NMB monitoring expose patients to inadequate blockade. The risk of this phenomenon warrants further study.
-
Randomized Controlled Trial Comparative Study
Effect of total intravenous vs volatile anesthetics on intraoperatively acquired electrically evoked compound action potential in children undergoing cochlear implant surgery: A randomized prospective study.
The purpose of the present study was to compare the effects of inhalational anesthesia to those of total intravenous anesthesia on intraoperative electrically evoked compound action potential (e-ECAP) thresholds in children undergoing cochlear implantation. ⋯ Volatile anesthetics result in higher e-ECAP thresholds in children, suggesting that e-ECAP thresholds acquired during inhalational anesthesia overestimate auditory nerve stimulation levels, which may cause discomfort postoperatively and adversely affect the child's adaptation to the implant. We recommend the use of total intravenous anesthesia for the measurement of the e-ECAP thresholds during cochlear implant surgery.
-
Randomized Controlled Trial
The effect of play distraction on anxiety before premedication administration: a randomized trial.
The majority of children scheduled to undergo surgery experience substantial anxiety in the preoperative holding area before induction of anesthesia. Pharmacological interventions aimed at reducing perioperative anxiety are paradoxically a source of stress for children themselves. Midazolam is frequently used as premedication, and the formula of this drug in Turkey is bitter. We aimed to assess the role of distraction in the form of playing with play dough (Play-Doh) on reducing premedication anxiety in children. ⋯ This study showed that distraction in the form of playing with play dough facilitated administration of oral midazolam in young children.
-
Randomized Controlled Trial Comparative Study
Effective volumes of 1.5% mepivacaine with different sodium concentration for ultrasound guided popliteal block.
To determine if a solution of 1.5% mepivacaine diluted with 5% dextrose, which decreases the sodium concentration by 30%, results in reduced volume requirements for a complete sensory block, in the case of an ultrasound guided popliteal nerve block. ⋯ A dilution of 1.5% mepivacaine with 30% less sodium concentration does not decrease volume requirement for ultrasound guided sciatic nerve block at popliteal level.