Journal of clinical anesthesia
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To determine if the laryngeal mask airway (LMA) seal is maintained during surgery, to evaluate the safety of an LMA leak test, and to determine the time course of the increase in LMA cuff pressure in vivo in the presence of nitrous oxide (N2O). ⋯ The LMA leak test can be safely performed. The airway seal provided by the LMA is well maintained during surgery. The increase in LMA cuff pressure during surgery in the presence of N2O is small and probably is not a cause for clinical concern. If positive pressure is to applied in the presence of an LMA, one should limit this pressure to below the LMA leak pressure so as to lower the risk of inflating the stomach with gas that may than leak around the LMA.
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To predict the inspired concentrations achieved when nitrous oxide (N2O)/oxygen mixtures are administered to patients by way of a nasal cannula. ⋯ Our analysis shows that the maximum FiN2O achievable by using a nasal cannula is limited to 0.21 even with a 6 L/min flow of 70% N2O for the defined respiratory parameters.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of alfentanil, esmolol, lidocaine, and thiopental sodium on the hemodynamic response to insertion of headrest skull pins.
To compare the effects of four techniques for preventing or blunting the hypertensive response to the insertion of Mayfield headrest skull pins: intravenous (IV) alfentanil (ALF), esmolol (ESM), thiopental sodium (TPL), and local anesthesia using plain lidocaine (Xylocaine; XYL). ⋯ IV ALF and local injection of XYL in the scalp prevent the hemodynamic response to the insertion of skull pins in anesthetized patients. Neither ESM nor TPL prevented the hypertensive response. Local anesthetic injection into the scalp requires coordination between the anesthesiologist and surgeon, it carries the risk of needle stick injury, and it must be repeated if the surgeon repositions the headrest. The rapid onset and short half-life of ALF, coupled with the absence of hemodynamic effects at the dose used, makes this drug an alternative to the use of XYL injection.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effect of ketorolac on bleeding time and postoperative pain in children: a double-blind, placebo-controlled comparison with meperidine.
To determine whether ketorolac 0.75 mg/kg would provide a comparable degree of analgesia to that of meperidine 1 mg/kg in terms of postoperative opioid requirements and pain scores in children undergoing surgeries associated with mild to moderate postsurgical discomfort. ⋯ Ketorolac provided analgesia comparable to that of meperidine and significantly reduced opioid requirements. Since ketorolac was not associated with a reduction in postoperative vomiting or length of stay, and in view of the uncertain risk of bleeding, it offers no advantage over meperidine in the management of mild to moderate acute postsurgical pain.
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Randomized Controlled Trial Comparative Study Clinical Trial
Patient-controlled intranasal analgesia (PCINA) for the management of postoperative pain: a pilot study.
To compare patient-controlled intranasal analgesia (PCINA) for post-operative pain management with ward-provided pain therapy. ⋯ PCINA provides an adequate, noninvasive mode of postoperative pain management. The PCINA device is easy to handle and offers new perspectives in the management of postoperative pain.