Journal of clinical anesthesia
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We present 12 case reports from patients treated with more than 600 mg of morphine per day. We found no "opioid-nonresponsive pain" under treatment with a combination of morphine and nonopioids, supplemented with coanalgesics where appropriate. ⋯ Serious adverse effects were not observed. Episodes of break-through pain, dysphagia, and dyspnea caused by far advanced cancer disease were seen frequently.
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To determine the influence of anesthetic technique and primary drug on operating room (OR) exit time (time between end of surgery until time patient exists the OR) after addition of desflurane to the hospital formulary. ⋯ Regional anesthesia and i.v. sedation were associated with faster OR exit times compared with general anesthesia. Despite desflurane's shorter elimination kinetics and recovery characteristics, use of this drug did not result in shorter exit times.
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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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Comparative Study Clinical Trial
Quantitative improvement in laryngoscopic view by optimal external laryngeal manipulation.
To determine the improvement in laryngoscopic view obtained using both the Macintosh and Miller blades by applying optimal external laryngeal manipulation (OELM). ⋯ We conclude that OELM can improve the laryngoscopic view by at least one whole grade, that the best way to determine OELM for an individual patient is on an empirical basis by manipulation of the larynx with the laryngoscopist's right hand, and that OELM should be an instinctive and reflex response to any "A" of 2, 3, or 4.
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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.