Journal of anesthesia
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Journal of anesthesia · Aug 2012
Letter Case ReportsAn experience with midazolam anaphylactoid reaction.
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Journal of anesthesia · Aug 2012
Randomized Controlled Trial Comparative StudyOral gastric tube-guided insertion of the ProSeal™ laryngeal mask is an easy and noninvasive method for less experienced users.
The ProSeal™ laryngeal mask airway (PLMA) can be more difficult to insert than the classic laryngeal mask, especially in patients who have a thin palate with a steep oropharyngeal curve. Here, an oral gastric (OG) tube-guided technique is considered as a method that makes it easier to successfully insert a PLMA. ⋯ OG tube-guided PLMA insertion is easier for less experienced users, trainees, and experts as well as less invasive for patients than the standard digital insertion.
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Journal of anesthesia · Aug 2012
Randomized Controlled TrialThe application of dexmedetomidine in children undergoing vitreoretinal surgery.
Dexmedetomidine is a highly selective alpha-2 adrenergic agonist that has a sedative effect and has been shown to reduce anesthetic requirements. It also has a sympatholytic effect, which may prove useful when used to blunt the sympathetic surge during intubation and extubation. However, its effects on intraocular pressure, hemodynamic stability, attenuation of extubation response, and emergence agitation remain unclear for pediatric patients undergoing vitreoretinal surgery. We focused on these effects in this study. ⋯ Dexmedetomidine 0.5 µg/kg had no effect on intraoperative hemodynamics or intraocular pressure, but attenuated the hemodynamic response to extubation and diminished emergence agitation in pediatric patients undergoing vitreoretinal surgery.
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Journal of anesthesia · Aug 2012
Randomized Controlled TrialEffect of wound infiltration with bupivacaine on postoperative analgesia in neonates and infants undergoing major abdominal surgery: a pilot randomized controlled trial.
Postoperative pain management is essential in the perioperative care of neonates and infants but it requires a high level of care. Wound infiltration with bupivacaine, a long-acting local anesthetic, is a simple method with minimal complications. However, studies on the effectiveness of wound infiltration in neonates and infants are lacking. The purpose of this study was to investigate the effectiveness of wound infiltration with bupivacaine for postoperative analgesia in neonates and infants undergoing abdominal surgery. ⋯ In neonates and infants, wound infiltration with bupivacaine had no significant effect on pain relief or fentanyl requirement during the first 24 h after major abdominal surgery.
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Journal of anesthesia · Aug 2012
Randomized Controlled TrialElectrostimulation with or without ultrasound-guidance in interscalene brachial plexus block for shoulder surgery.
In a prospective controlled trial to compare conventional interscalene brachial plexus block (ISBPB) using anatomic landmarks and electro-stimulation with a combined technique of ultrasound guidance followed by nerve stimulation, 60 patients were randomized into 2 matched equal groups: Group A using nerve stimulation (NS) alone and Group B using the combination of ultrasound and NS. The time to detect the plexus (3.9 ± 4 min in Group A and 3.3 ± 1.4 min in Group B) was not significantly different. We needed to reposition the needle once (n = 13) or twice (n = 4) in Group B. ⋯ None of the patients needed general anaesthesia. There were no significant differences between postoperative pain, motor power, or patient's satisfaction. ISBPB seems similarly effective using electro-stimulation and ultrasound if performed by experienced anesthesiologists.