Journal of anesthesia
-
Journal of anesthesia · Jan 2005
Case ReportsLow-dose vasopressin infusion in patients with severe vasodilatory hypotension after prolonged hemorrhage during general anesthesia.
We report the successful use of a low-dose vasopressin (VP) infusion to recover a hypotensive crisis in patients who suffered persistent hypotension after prolonged hemorrhage during general anesthesia. VP was infused in two posthemorrhagic vasodilatory shock patients when they remained persistently hypotensive despite adequate fluid resuscitation and infusions of pharmacological doses of catecholamines. ⋯ No adverse cardiac effects were observed during VP infusions in these patients. During vasodilatory shock after prolonged and severe hemorrhage, VP seems to be effective in reversing hypotension and decreasing the need for exogenous cathecholamines while preserving cardiac function and critical organ blood flow.
-
Journal of anesthesia · Jan 2005
Randomized Controlled Trial Comparative Study Clinical TrialIs penile block better than caudal epidural block for postcircumcision analgesia?
To compare caudal and penile block for post-operative analgesia in children undergoing circumcision with respect to efficacy, complication rates, and parental satisfaction. ⋯ Penile and caudal block are equally effective for postcircumcision analgesia and neither is associated with serious complications. Anesthesiologist preference should be the deciding factor in choosing one technique over the other.
-
Journal of anesthesia · Jan 2005
Randomized Controlled Trial Clinical TrialPatient-controlled epidural analgesia during labor using ropivacaine and fentanyl provides better maternal satisfaction with less local anesthetic requirement.
To test the hypothesis that patient-controlled epidural analgesia (PCEA) using ropivacaine and fentanyl provides better maternal satisfaction and less anesthetic requirement than conventional continuous epidural infusion (CEI) during labor, we studied 58 uncomplicated parturients (singleton, vertex presentation). ⋯ We found that PCEA was an effective means of providing optimal analgesia, with better satisfaction during labor and less local anesthetic requirement.
-
Journal of anesthesia · Jan 2005
Randomized Controlled TrialLandiolol attenuates the cardiovascular response to tracheal intubation.
The objective of this prospective study was to compare the cardiovascular responses with or without landiolol to the induction of general anesthesia and tracheal intubation. ⋯ Continuous administration of landiolol before tracheal intubation results in the attenuation of cardiovascular response for tracheal intubation.
-
Journal of anesthesia · Jan 2005
ReviewDrugs to facilitate recovery of neuromuscular blockade and muscle strength.
Several drugs that quicken recovery from neuromuscular blockade caused by vecuronium in anesthetized patients are reviewed. Ulinastatin, a protease inhibitor, is thought to promote the release of acetylcholine at the neuromuscular junction and increases hepatic blood flow and urine volume. For this reason, ulinastatin quickens recovery from neuromuscular blockade in anesthetized patients receiving vecuronium. ⋯ Therefore, recovery from neuromuscular blockade is hastened. Nicorandil enhances membrane K+ conductance in skeletal muscle and increases contraction of the skeletal muscle. Thus, nicorandil quickens recovery from neuromuscular blockade.