Journal of anesthesia
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Journal of anesthesia · Apr 2012
Randomized Controlled TrialComparison between propofol and dexmedetomidine in postoperative sedation after extensive cervical spine surgery.
Patients undergoing extensive cervical spine surgery (ECSS) occasionally require emergency reintubation due to postoperative airway complications. To avoid it, an endotracheal tube is retained in patients maintained under sedation overnight. This study was conducted to determine whether dexmedetomidine would be superior in sedative effects to propofol for postoperative sedation after ECSS. ⋯ Both sedatives are efficacious after ECSS; however, dexmedetomidine decreased heart rate and required higher dose of dopamine.
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Journal of anesthesia · Apr 2012
Randomized Controlled Trial Comparative StudyComparison of the effects of fentanyl, remifentanil, and dexmedetomidine on neuromuscular blockade.
The aim of our study was to compare the effects of fentanyl, remifentanil, and dexmedetomidine on neuromuscular blockade under sevoflurane anesthesia. ⋯ Dexmedetomidine infusion increased the duration of neuromuscular blockade with vecuronium during general anesthesia. In addition to analgesic and sedative effects, dexmedetomidine may enhance the duration of neuromuscular blockade and may be used as an adjuvant anesthetic during general anesthesia.
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Journal of anesthesia · Apr 2012
Case ReportsRemifentanil use for cesarean section in a patient with intracranial re-ruptured arteriovenous malformation.
We describe the successful administration of remifentanil as part of the anesthetic technique used for cesarean section performed under general anesthesia in a 24-year-old woman with intracranial re-hemorrhage caused by re-ruptured arteriovenous malformation. A low dose of remifentanil was useful to obtund the hypertensive response during induction and maintenance of anesthesia without neonatal respiratory depression.
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Journal of anesthesia · Apr 2012
Case ReportsRetrograde intubation during laryngeal cleft repair on cardiopulmonary bypass.
Retrograde intubation is part of the difficult airway algorithm in the American Society of Anesthesiologists, but its usage is rare in small pediatric patients with the advent of new intubation techniques. We present our experience of retrograde intubation for a 4-month-old patient who presented for laryngeal cleft repair on cardiopulmonary bypass. This case highlights the unique place for retrograde intubation in small patients in the current era.
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Journal of anesthesia · Apr 2012
Case ReportsSuccessful treatment of severe asthma-associated plastic bronchitis with extracorporeal membrane oxygenation.
We describe a case of near-fatal asthma requiring extracorporeal membrane oxygenation (ECMO). The patient presented with severe respiratory distress, which was not responsive to conventional pharmacological therapy. The patient also failed to respond to mechanical ventilation and thus was placed on venovenous ECMO for temporary pulmonary support. ⋯ Aggressive airway hygiene with frequent bronchoscopies and application of biphasic cuirass ventilation for facilitation of secretion clearance were performed to improve the patient's respiratory status. The patient achieved a full recovery and suffered no neurological sequelae. This case illustrates that aggressive pulmonary hygiene with ECMO is a useful therapy for patients with asthma-associated plastic bronchitis.