Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
The effectiveness of oral clonidine as a sedative/anxiolytic and as a drug to blunt the hemodynamic responses to laryngoscopy.
To determine the effects of oral clonidine premedication on sedative, anxiolytic, and hemodynamic responses during the immediate preoperative period, laryngoscopy/intubation, and postanesthetic recovery. ⋯ Oral clonidine 0.2 mg was effective in reducing the level of behavioral and hemodynamic responses preoperatively and in blunting systolic hypertension produced by prolonged laryngoscopy.
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Randomized Controlled Trial Clinical Trial
Intubating conditions after pipecuronium bromide: the influence of dose and time.
To determine the intubating conditions following the administration of pipecuronium bromide in doses of two (0.07 mg/kg) or three (0.1 mg/kg) times ED95 (average dose that gives 95% block of the first twitch). ⋯ Pipecuronium has a relatively rapid onset. The trachea could be intubated successfully in 11/2 minutes with a dose of either 0.07 mg/kg or 0.1 mg/kg. If the clinical situation requires perfect relaxation with no movement or bucking, we recommend waiting at least 21/2 minutes.
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Randomized Controlled Trial Comparative Study Clinical Trial
Adaptive feedback-controlled infusion versus repetitive injections of vecuronium in patients during isoflurane anesthesia.
To compare vecuronium requirements using repetitive injections and a model-based, closed-loop, feedback-controlled infusion during isoflurane anesthesia. ⋯ The model-based adaptive feedback system proved to be useful in maintaining a stable degree of paralysis, adjusting relaxant input to individual demand, and minimizing drug requirement, as compared with repetitive injections.
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Randomized Controlled Trial Clinical Trial
The clinical effectiveness of epidural bupivacaine, bupivacaine with lidocaine, and bupivacaine with fentanyl for labor analgesia.
To examine the efficacy of bupivacaine alone and in combination with lidocaine or fentanyl for epidural analgesia during labor. ⋯ Epidurally administered fentanyl safely extended the duration of labor analgesia while reducing bupivacaine dose requirements and magnitude of motor block. In this setting, the combination of bupivacaine and lidocaine offered no clinical advantage over bupivacaine alone.
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A 25-year-old healthy patient developed bilateral tension pneumothorax during general endotracheal anesthesia due to a defective anesthesia breathing circuit filter. Prompt diagnosis and treatment of the pneumothorax was facilitated by the use of capnography and pulse oximetry. The manufacturing process of the breathing circuit and filter that made this accident possible has since been corrected by the manufacturer. Anesthesiologists must be alert to the possibility of such accidents with any breathing system using bacterial filters.