Journal of clinical anesthesia
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Clinical Trial
The effect of laparoscopic cholecystectomy on respiratory compliance as determined by continuous spirometry.
To evaluate the effect of pneumoperitoneum on dynamic compliance during laparoscopic cholecystectomy with continuous spirometry. ⋯ Increased intraabdominal pressure during laparoscopic cholecystectomy causes a significant, but fully reversible, decrease in dynamic compliance. On-line spirometry with a graphic display of the pressure-volume loop facilitates the immediate discovery of these alterations.
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Criteria for determination of brain death in adults have been defined. Spinal cord reflexes may persist after brain death. We present the case of a brain dead patient who had a complex spinal automatism resulting in head shaking and arm extension. The report reviews guidelines for the diagnosis of brain death and discusses complex spinal cord reflexes in brain dead patients.
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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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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.