Journal of clinical anesthesia
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Randomized Controlled Trial Clinical Trial
0.2% ropivacaine with or without fentanyl for patient-controlled epidural analgesia after major abdominal surgery: a double-blind study.
To evaluate the effects of adding low concentration of fentanyl to 0.2% ropivacaine when providing patient-controlled epidural analgesia (PCEA) outside the Post-Anesthesia Care Unit. ⋯ A thoracic epidural infusion of 0.2% ropivacaine, with or without fentanyl, provided effective pain relief in most patients with a very low degree of motor blockade. Adding 2 microg/ml fentanyl to 0.2% ropivacaine reduced total consumption of local anesthetic solution and need for incremental doses, but did not provide clinically relevant advantages in quality of pain relief and incidence of motor block, leading to a significant decrease in peripheral SpO(2), lasting up to 48 hours after surgery.
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Randomized Controlled Trial Clinical Trial
Warmed humidified inspired oxygen accelerates postoperative rewarming.
To investigate the efficacy of warmed, humidified inspired oxygen (O(2)) for the treatment of mildly hypothermic postoperative patients. ⋯ Warming and humidifying inspired O(2) hastens recovery from hypothermia in postoperative patients.
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Comparative Study Clinical Trial
Transesophageal echocardiographic assessment of pulmonary arterial and venous flow during high-frequency jet ventilation.
To evaluate high-frequency jet ventilation (HFJV) effects on pulmonary arterial and venous flow compared to those of intermittent positive-pressure ventilation (IPPV) by using pulsed Doppler transesophageal echocardiography. ⋯ Our results suggest that, in comparison to IPPV, HFJV significantly decreases pulmonary arterial pressure and left atrial pressure, resulting in significant increases in cardiac output and ejection fraction in healthy anesthetized adults.
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To determine the perioperative mortality and intraoperative morbidity according to operative procedure and postoperative period for American Society of Anesthesiologists' Physical Status (ASA-PS) V category patients. ⋯ The ASA-PS V classification is determined subjectively rather than objectively, and can be variable within its parameters, depending on the individual interpretation of ASA classification, patient population, case severity, surgical and anesthesia factors, and the year of the study. Even though immediate perioperative mortality decreased in our patient population, late postoperative mortality increased during the same time period, possibly demonstrating a shift in mortality time rather than an absolute decrease in overall mortality. Although the ASA-PS V category was never intended to be a predictor of outcome, it correlates with perioperative mortality as well as or even better than other classifications of mortality and morbidity. The decreased mortality in the ASA-PS V patient population may be related to different factors, which are beyond the scope of this study.
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To evaluate the effects of unilateral stellate ganglion blockade on left ventricular function. ⋯ In patients without cardiovascular disease, unilateral denervation of the left ventricle after stellate ganglion block produces no clinical deleterious effects on left ventricular function.