Journal of clinical anesthesia
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Outpatient general anesthesia: a comparison of a combination of midazolam plus propofol and propofol alone.
To compare the hemodynamics, efficacy, safety, and postoperative recovery of patients following the use of either midazolam plus propofol or placebo plus propofol for induction and maintenance of general anesthesia for outpatient surgical procedures of less than two hours' duration. ⋯ Concomitantly administered midazolam and reduction-concentration propofol did not exacerbate the well-described hypotensive effects of full-strength propofol during induction of anesthesia. The time to intubation was equivalent with the combination of midazolam/propofol as compared with propofol alone. Recovery from the two regimens was not significantly different. However, reduced recall of perioperative events was observed more often in the midazolam/propofol regimen compared with propofol alone.
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To obtain data about the safety and efficacy of the size 5 laryngeal mask airway (LMA), which is a scaled-up version of the size 4 and is generally recommended for patients over 90 kg, for positive pressure ventilation (PPV), ease of insertion, oropharyngeal and gastric insufflation pressures, fiberoptic positioning, and complication rates. ⋯ Positive pressure ventilation with the size 5 LMA is safe and effective with a low failure/problem rate using tidal volumes of 8 to 10 ml/kg, even in those patients who are moderately obese. The device is suitable for patients weighing under 90 kg in whom the seal with the size 4 is inadequate.
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Clinical Trial Controlled Clinical Trial
Echocardiographic evaluation of global left ventricular function during high thoracic epidural anesthesia.
To assess the effects of high thoracic epidural anesthesia on left ventricular (LV) diastolic filling and systolic function in patients without heart disease. ⋯ High thoracic epidural anesthesia causes a decrease in CO without changing LV ejection and diastolic filling performance in healthy subjects.
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Comparative Study Clinical Trial Controlled Clinical Trial
Superiority of multi-orifice over single-orifice epidural catheters for labor analgesia and cesarean delivery.
To investigate whether a change from a single-orifice to multi-orifice catheter could reduce the incidence of inadequate epidural blocks requiring replacement of the epidural catheter in obstetric patients. ⋯ The multi-orifice design offers significant advantages over the single-orifice type for obstetricepidural analgesia.
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Comparative Study Clinical Trial
A comparison of propofol and remifentanil during monitored anesthesia care.
To compare remifentanil, an esterase-metabolized opioid, to a standard propofol-based sedation technique for monitored anesthesia care (MAC). ⋯ Remifentanil provided comparable intraoperative conditions and patient comfort at a lower sedation level compared with propofol. However, remifentanil was associated with greater respiratory depression and a longer time to home readiness.