Journal of anesthesia
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Journal of anesthesia · Jan 2009
Case ReportsCombination of oral ketamine and midazolam as a premedication for a severely autistic and combative patient.
Patients with impaired ability to understand and communicate can be difficult to manage perioperatively. They frequently require lateral thinking on the part of the anesthesiologists to make the induction process as smooth as possible. ⋯ A combination of oral ketamine and midazolam was mixed in the beverage Dr Pepper to mask the taste and the appearance of the drugs. The unique flavor of Dr Pepper is well suited to increase the palatibility and the acceptability of medications in children and patients with developmental delay.
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Journal of anesthesia · Jan 2009
Randomized Controlled TrialThe impact of two arterial catheters, different in diameter and length, on postcannulation radial artery diameter, blood flow, and occlusion in atherosclerotic patients.
Arterial cannulation is a common intervention in anesthesia practice. However, the success rates and complications of radial arterial cannulation with 20-G or smaller catheters in patients with atherosclerosis have been underevaluated. The aim of this prospective randomized study was to compare the efficacy of and complications with 20- and 22-G catheters for radial arterial cannulation in atherosclerotic patients. ⋯ A 22-gauge catheter for radial arterial cannulation in patients with atherosclerosis provides unchanged postcannulated radial artery diameter, decreases postcannulation complications, and improves the first-attempt success rate.
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Journal of anesthesia · Jan 2009
Randomized Controlled Trial Comparative StudyIs there an advantage in using low-dose intrathecal bupivacaine for cesarean section?
Spinal anesthesia for cesarean section is associated with a high incidence of maternal hypotension. The aim of this study was to assess the efficacy of low-dose bupivacaine with fentanyl to reduce the incidence of hypotension in spinal anesthesia for cesarean section. ⋯ The development of hypotension after spinal block in subjects undergoing cesarean section was not prevented despite low-dose (4 mg) bupivacaine plus 25 microg fentanyl, but the severity of maternal hypotension, and the number of ephedrine treatments and the total dose of ephedrine were decreased.
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Journal of anesthesia · Jan 2009
Randomized Controlled TrialEffects of intravenous adenosine 5'-triphosphate on intraoperative hemodynamics and postoperative pain in patients undergoing major orofacial surgery: a double-blind placebo-controlled study.
We conducted a double-blind placebo-controlled study to investigate the effects of the intraoperative intravenous infusion of adenosine 5'-triphosphate (ATP) on intraoperative hemodynamics and postoperative pain in patients undergoing major orofacial surgery. ⋯ Our data suggest that intraoperative ATP infusion can blunt hemodynamic responses to surgical stimuli and produce prolonged analgesia in patients undergoing major orofacial surgery.
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Journal of anesthesia · Jan 2009
Randomized Controlled TrialIntravenous famotidine does not always change core temperature during general anesthesia.
It has been reported that oral premedication with the H(2) receptor antagonist famotidine augmented intraoperative hypothermia. We again investigated whether the H(2) receptor antagonist famotidine significantly affected body temperature during open abdominal surgery under general anesthesia. We studied 20 female patients undergoing elective gynecological surgery. ⋯ T(Tym) gradually and significantly decreased in both groups during anesthesia, and no significant differences in these values were observed between the two groups. Grad(a-f) did not differ significantly between the two groups during anesthesia. We conclude that intravenous famotidine does not always change the core temperature during general anesthesia.