Journal of anesthesia
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Journal of anesthesia · Oct 2012
Prediction of volume responsiveness using pleth variability index in patients undergoing cardiac surgery after cardiopulmonary bypass.
The pleth variability index (PVI) is derived from analysis of the plethysmographic curve and is considered to be a noninvasive parameter for prediction of volume responsiveness. The aim of our prospective clinical study was to evaluate if volume responsiveness can be predicted by PVI in patients undergoing cardiac surgery after cardiopulmonary bypass. ⋯ For consideration of fluid responsiveness PVI is as accurate as SVV in patients after cardiopulmonary bypass. Methodological limitations such as instable cardiac rhythm after cardiopulmonary bypass and right- or left ventricular impairment seem to be responsible for low specificity and positive predictive values in both parameters PVI and SVV.
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Journal of anesthesia · Oct 2012
Randomized Controlled TrialIntravenous butorphanol administration reduces intrathecal morphine-induced pruritus after cesarean delivery: a randomized, double-blind, placebo-controlled study.
Pruritus associated with intrathecal opioid administration is a common side effect. There is evidence that κ-opioid receptor agonists have antipruritic activity. Butorphanol has agonist actions at both κ-opioid and μ-opioid receptors. This study was designed to evaluate the antipruritic efficacy of butorphanol after intrathecal morphine administration in the setting of a randomized, double-blind study of parturients undergoing cesarean section. ⋯ Administration of intravenous butorphanol after delivery of the baby can reduce pruritus that has been induced by intrathecal morphine administration in cesarean delivery with combined spinal-epidural anesthesia.
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Journal of anesthesia · Oct 2012
Impact of remifentanil use on early postoperative outcomes following brain tumor resection or rectal cancer surgery.
Remifentanil, a mu-opioid receptor agonist, has important characteristics for neuroanesthesia, but data about its effects on postoperative recovery and mortality are currently lacking. ⋯ Our data suggest a possible association between use of remifentanil and better early postoperative recovery for patients undergoing neurosurgery with craniotomy. Further studies, including a randomized controlled trial, are required to confirm the present results.
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Journal of anesthesia · Oct 2012
Peribulbar block in patients scheduled for eye procedures and treated with clopidogrel.
Our hypothesis was that the continuation of clopidogrel does not increase the risk of eye hemorrhage, compared to patients not treated with clopidogrel, when a peribulbar anesthesia is required. Our prospective case-control study enrolled two groups of 1,000 patients scheduled for intraocular eye surgery requiring a peribulbar block. Patients treated with clopidogrel were included in group A (1,000 patients). ⋯ No grade 2, 3, or 4 hemorrhage was encountered. There was no significant difference in the grading of hemorrhage between the groups (p = 0.017). Clopidogrel was not associated with a significant increase in potentially sight-threatening local anesthetic complications.