Journal of clinical anesthesia
-
Randomized Controlled Trial Clinical Trial
Pressure support improves efficiency of spontaneous breathing during inhalation anesthesia.
To determine if reducing respiratory muscle load or increasing tidal volume (VT) with pressure support (PS) would improve ventilatory efficiency by reducing respiratory rate (RR) and resting PaCO2. ⋯ PS titrated to produce a near normal VT improves the efficiency of spontaneous breathing by lowering RR and PaCO2 while preserving hemodynamic homeostasis in patients undergoing inhalation anesthesia. Lesser PS levels will unload the respiratory muscles, but have no effect on RR or PaCO2.
-
To investigate topographical changes in electroencephalographic (EEG) frequencies and spectral power density in relation to different surgical procedures (abdominal hysterectomy versus mastectomy) during steady-state isoflurane-nitrous oxide (N2O) anesthesia. ⋯ These results show that specific surgical procedures may induce EEG slow wave activity to a different degree. The EEG response varied in relation to the surgical procedure and/or the intensity of noxious stimulation. Mastectomy resulted in the appearance of theta activity whereas, during laparotomy, the EEG frequency content was shifted to delta waves. The topographical analysis indicates spatial inhomogeneities in the EEG responses with a dominance at frontal areas. From this findings, it may be concluded that the electrode montage used for intraoperative EEG recordings has to be carefully selected.
-
EMLA cream is an acronym for eutectic mixture of local anesthetics. It contains lidocaine and prilocaine creams. A eutectic preparation, applied topically, penetrates into the dermis after an application period of 1 to 2 hours. This case report describes the successful treatment with EMLA cream of post-herpetic neuralgia, which was resistant to other modes of therapy, and briefly discusses the pharmacology of EMLA cream.
-
Comparative Study Clinical Trial Controlled Clinical Trial
Recovery from mivacurium-induced neuromuscular blockade after neurosurgical procedures of long duration.
To determine if recovery following prolonged (5 hours in length or greater) infusions of mivacurium is different from recovery after single bolus administration. ⋯ Recovery following mivacurium by prolonged continuous infusion was slower than that observed after single bolus administration in this patient population. Clinically, this increased time to recovery may be insignificant.
-
This report describes the perioperative management of a 70-year-old man undergoing bilateral pelvic lymphadenectomy. Because of concerns regarding this patient's high risk for myocardial ischemia, the four-hour surgical procedure, which included the formation of pneumoperitoneum, was performed during epidural anesthesia with minimal sedation. The anesthetic implications of pneumoperitoneum during regional anesthesia are discussed.