Journal of clinical anesthesia
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Randomized Controlled Trial Clinical Trial
Remifentanil as an adjuvant during desflurane anesthesia facilitates early recovery after ambulatory surgery.
To investigate the effect of using a remifentanil infusion during desflurane anesthesia on the early recovery profile and side effects. ⋯ The adjunctive use of a remifentanil infusion (0.07 +/- 0.03 microgram.kg-1.min-1) during desflurane-N2O anesthesia facilitated early recovery without increasing PONV, pain, or the need for rescue medication after laparoscopic surgery.
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Randomized Controlled Trial Clinical Trial
Changes in respiratory pattern and arterial blood gases during sedation with propofol or midazolam in spinal anesthesia.
To investigate changes in respiratory pattern and arterial blood gases during sedation with propofol or midazolam in spinal anesthesia. ⋯ Significant decreases in %RC and pO2 during propofol sedation seem to depend on paradoxical respiration due, in part, to upper airway obstruction; therefore, attention should be directed to the respiratory pattern during sedation, especially with propofol.
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Randomized Controlled Trial Clinical Trial
Effects of sympathetic blockade on the efficiency of forced-air warming during combined spinal-epidural anesthesia for total hip arthroplasty.
To evaluate if active cutaneous warming of the two upper limbs with reflex vasoconstriction is less effective in maintaining intraoperative normothermia than warming the vasodilated unoperated lower limb during combined spinal-epidural anesthesia (CSE). ⋯ Forced-air cutaneous warming allows the anesthesiologist to maintain normothermia during CSE for total hip replacement even if the convective blanket is placed on a relatively small skin surface with reflex vasoconstriction. Placing the forced-air warming system on the vasodilated unoperated lower limb may be troublesome to the surgeons and does not offer clinically relevant advantages in warming efficiency.
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To determine the influences of age and gender on the dose response and the time course of effect of atracurium. ⋯ Age and gender have significant effects on the dose response and time course of effect of atracurium. Older patients and women are more sensitive to atracurium-induced neuromuscular block than are young patients and men.
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We describe the case of a parturient who developed dysphagia shortly after the intrathecal injection of a local anesthetic-opioid combination for cesarean section. Dysphagia was the only symptom of cephalad spread of the spinal anesthetic, and it was not associated with a "high" motor or sensory block. Although it resolved spontaneously, the dysphagia was extremely distressing to the patient. We conclude that dysphagia, even in the absence of an overtly "high spinal," should be added to the possible side effects of intrathecal local anesthetic-opioid administration in parturients.