Journal of clinical anesthesia
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Randomized Controlled Trial Clinical Trial
Flow increases with an enlarging intravenous catheter.
To determine the increase in flow of a hydratable enlarging intravenous (IV) catheter in anesthetized patients. ⋯ Flow through enlarging IV catheters placed in anesthetized patients increases after 1 hour. The percentage increase in flow is not as great as previously seen in vitro and may be due to skin, vein, and subcutaneous tissues preventing complete expansion.
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To determine the sites and rates of the leakage of disposable breathing circuits. ⋯ Most disposable breathing circuits can be used safely for closed-circuit anesthesia, as the leakage volume is too small to be of clinical importance. The variation in the leakage rates stresses the importance of quality control of the connector seals.
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To assess the resistance of a new endotracheal tube to penetration and ignition by a carbon dioxide (CO2) laser at a clinically relevant power setting. ⋯ The protective coating of the Xomed Laser-Shield II is laser-resistant, but the unprotected silicone proximal and distal to the cuff is laser-vulnerable and can, under certain conditions, promote a blowtorch phenomenon. This tube would be acceptable for use in oral and pharyngeal laser surgery, but we recommend its use only in well-ventilated areas, out of concern for exposure to the products of the pyrolysis of Teflon, specifically the development of polymer-fume fever.
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A 69-year-old white female presented for corneal transplant, but her numerous medical problems placed her at unacceptably high risk for prolonged general anesthesia. Routine monitored anesthesia care measures would not have provided her or the surgeon the comfort and repose necessary for a successful outcome. We describe anesthetic management for ophthalmic surgery, using epidural anesthesia in conjunction with retrobulbar block, in an elderly patient at high risk for general anesthesia whose intractable back and leg pain would have otherwise precluded her cooperation in maintaining a motionless operative field.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparative effects of desflurane and isoflurane on vecuronium-induced neuromuscular blockade.
To evaluate the neuromuscular effects of a nondepolarizing muscle relaxant (vecuronium) during anesthesia with equipotent concentrations of either desflurane or isoflurane. ⋯ Vecuronium has similar neuromuscular effects when administered in the presence of desflurane 3% and isoflurane 0.6%.