Journal of clinical anesthesia
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We report a case in which sufentanil was given to a patient who was already taking both a monoamine oxidase (MAO) inhibitor and a tricyclic antidepressant. Anecdotal reports have recommended discontinuing MAO inhibitors 2 to 3 weeks prior to elective surgery. ⋯ She was given an uneventful elective anesthetic with measures to minimize the risk of an adverse drug reaction involving the antidepressants she was taking. Our experience suggests that the use of an opioid other than meperidine may allow the anesthetist to proceed cautiously to provide an anesthetic for an elective surgery patient who is also currently receiving MAO inhibitor therapy.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of cardiovascular responses to airway management: fiberoptic intubation using a new adapter, laryngeal mask insertion, or conventional laryngoscopic intubation.
To evaluate the circulatory effects of fiberoptic intubation with a newly developed mask adapter and to compare these effects with those obtained with a conventional laryngoscope and laryngeal mask airway with general anesthesia. ⋯ Fiberoptic intubation with general anesthesia using the newly developed mask adapter offers an advantage over the standard laryngoscope for patients in whom pressor response of intubation is potentially hazardous.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of intravenous ketorolac and alfentanil as supplements to propofol anesthesia for diagnostic panendoscopy.
To determine if ketorolac tromethamine is an acceptable alternative to alfentanil as a supplement to propofol for diagnostic panendoscopy. ⋯ Supplementation of propofol anesthesia with ketorolac is an efficacious alternative to supplementation with alfentanil. The faster recovery in the ketorolac group is explained by the mostly peripheral effect of this drug, whereas the slow decline in the alfentanil concentration at the effective site may be responsible for slower emergence from anesthesia.
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To assess the factors affecting the distance from skin to epidural space. ⋯ Both the patient's weight and position during epidural needle placement are important factors influencing DS-ES. A change from the sitting to the lateral position may increase DS-ES, causing catheter dislodgment and consequent inadequate analgesia. Clinical studies relating DS-ES to inadequate analgesia must take these factors into account.
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Randomized Controlled Trial Comparative Study Clinical Trial
A random trial comparing recovery after midazolam-alfentanil anesthesia with and without reversal with flumazenil, and standardized neurolept anesthesia for major gynecologic surgery.
To compare the recovery characteristics of total intravenous anesthesia (TIVA) using midazolam-alfentanil, with or without reversal with flumazenil to a standardized neurolept anesthesia with nitrous oxide (N2O). ⋯ TIVA with midazolam and alfentanil can be used for major gynecologic surgery. Recovery in the neurolept group was equal to recovery in the TIVA group without reversal, and flumazenil improves the recovery after midazolam anesthesia. Overall, in comparison with the neurolept technique no major advantage could be demonstrated using TIVA with midazolam-alfentanil.