Journal of clinical anesthesia
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Randomized Controlled Trial Clinical Trial
Use of patient-controlled analgesia with alfentanil for extracorporeal shock wave lithotripsy.
To compare the efficacy of patient-controlled analgesia (PCA) to physician-controlled analgesia in patients undergoing extracorporeal shock wave lithotripsy (ESWL). ⋯ PCA is a useful alternative to physician-controlled analgesia during ESWL since it provides equivalent pain control while using less alfentanil.
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Randomized Controlled Trial Comparative Study Clinical Trial
Does monitoring end-tidal isoflurane concentration improve titration during general anesthesia?
To assess the value of end-tidal anesthetic gas monitoring with respect to intraoperative hemodynamic stability and recovery times. ⋯ This study suggests that end-tidal isoflurane monitoring does not improve the titration of isoflurane during general anesthesia.
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Randomized Controlled Trial Clinical Trial
The effect of cricoid pressure application on airway patency.
To assess the incidence of upper airway obstruction associated with the application of cricoid pressure (Sellick's maneuver) by experienced anesthetists. ⋯ The use of manual cricoid pressure, even by experienced anesthetists, causes a degree of airway obstruction and can cause complete airway occlusion.
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With improvements in the surgical technique for orthotopic liver transplantation, patients with significant underlying systemic disease are considered candidates for transplantation, thus increasing the complexity of the medical management of these patients and necessitating additional monitoring in order to minimize the anesthetic risk. We describe the anesthetic management of orthotopic liver transplantation for a patient with severe hypertrophic cardiomyopathy and mitral insufficiency. In this case, transesophageal echocardiography proved useful in the management of the postreperfusion period of the surgical procedure.
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To elucidate risk factors for apnea in preterm infants discharged from the hospital and in full-term healthy infants. To determine the efficacy of real-time cardiopulmonary monitoring versus computerized storage and retrieval for infants at risk. ⋯ Although it is easier to predict postoperative respiratory dysfunction in previously sick or very young infants, absolute predictability for all neonates remains elusive. Clinical monitors with both storage and retrieval capabilities and real-time monitoring increase our ability to detect significant events in children at risk for apnea after herniorrhaphy.