Journal of clinical anesthesia
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Comparative Study
Computerized patient anesthesia records: less time and better quality than manually produced anesthesia records.
To compare manual and computerized anesthesia information management systems (AIMS's) with respect to time demands on the anesthetist and record quality. ⋯ The concern that the introduction of computerized AIMS's may complicate the anesthesia working environment by requiring more time than manual AIMS's and thus detracting from direct patient care is not supported by this study. In fact, this computer approach not only required less time but also produced a more complete and higher-quality record than did the manual AIMS.
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Case Reports
General anesthesia for cesarean section in a parturient with a single ventricle and pulmonary atresia.
The successful management of a cesarean section in a parturient with a single ventricle and pulmonary atresia using general anesthesia is discussed. After cyanosis at birth, the patient underwent cardiac catheterization, which showed an apparent severe tetralogy of Fallot, atresia of the main pulmonary artery (PA), and a large patent ductus arteriosus. When she was 7 months of age, a Blalock-Taussig shunt (right subclavian artery to right PA) was done. ⋯ The patient was then taken to the operating room electively, and an opioid-based general anesthetic was administered. Both mother and infant did well. This case is presented because the physiology of the patient's lesion and her unusual social history presented challenges for her anesthetic management.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of dexmedetomidine and midazolam sedation and antagonism of dexmedetomidine with atipamezole.
To evaluate the effects of dexmedetomidine, an alpha-2 agonist, as an intravenous sedative drug and the effects of atipamezole, an alpha-2 antagonist, on recovery. ⋯ Atipamezole is an effective antagonist for reversing psychomotor impairment following dexmedetomidine sedation.
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Meta Analysis
Postoperative patient-controlled analgesia: meta-analyses of initial randomized control trials.
To compare outcomes during conventional analgesia (as-needed intramuscular dosing) and patient-controlled analgesia (PCA) in postoperative patients by analyzing data from published comparative trials. ⋯ Patient preference strongly favors PCA over conventional analgesia. Patients using PCA also obtain better pain relief than those using conventional analgesia, without an increase in side effects. Favorable effect of PCA upon analgesic usage and length of hospital stay did not in the initial trials attain statistical significance. Nonetheless, the favorable trends in the mean effect sizes for both outcomes argue that further studies of both outcomes should be performed to determine whether the favorable impact of PCA upon either may become statistically significant if larger numbers of patients are enrolled.
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Randomized Controlled Trial Comparative Study Clinical Trial
Spinal or systemic analgesia after extensive spinal surgery: comparison between intrathecal morphine and intravenous fentanyl plus clonidine.
To compare two different methods of postoperative analgesia after extensive spinal fusion. ⋯ This study shows that there is a major risk of respiratory depression with a single intrathecal dose of morphine 0.3 mg to control postoperative pain after scoliosis surgery. Systemic clonidine-fentanyl may be a possible approach to the postoperative pain treatment of this surgery.