Journal of anesthesia
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Journal of anesthesia · Aug 2013
Randomized Controlled Trial Clinical TrialThe effects of anesthetic technique and ambient temperature on thermoregulation in lower extremity surgery.
The purpose of our study was to determine the effects of anesthetic technique and ambient temperature on thermoregulation for patients undergoing lower extremity surgery. ⋯ There were no significant differences in thermoregulation among anesthetic techniques. Room temperature affected thermoregulation in Group GA.
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Journal of anesthesia · Aug 2013
Randomized Controlled TrialA pilot study to compare epidural identification and catheterization using a saline-filled syringe versus a continuous hydrostatic pressure system.
We are introducing a new continuous hydrostatic pressure system for identification and catheterization of epidural space in adults. One hundred and eight patients scheduled for elective endoscopic urological procedures were enrolled in this prospective randomized study. They were assigned to perform loss of resistance epidural technique by either the conventional saline-filled syringe (group C) or the new pressure technique (group P). ⋯ Significant reduction was found in group P versus group C concerning time to identify epidural space [20 (6-40) vs. 60.5 (23-75) s with p = 0.001], number of attempts [1 (1-2) vs. 1 (1-4) with p = 0.02] and motor block [1 (0-3) vs. 2 (0-2) with p = 0.02], respectively. No significant difference in epidural catheterization, sensory block, quality of anesthesia and incidence of side effects. We concluded that this new technique is an easy way to identify epidural space using available tools in the operating room.
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Journal of anesthesia · Aug 2013
Randomized Controlled TrialA novel method for SLIPA™ size selection, for adult patients, on the basis of chamber length.
Nowadays the size of the streamlined liner of the pharynx airway (SLIPA™) is selected by matching the width of the thyroid cartilage of the patient to the widest dimension of the SLIPA™. The objective of this work was to improve the method of selection by matching the distance between the otobasion inferius and the most inferior margin of the cricoid cartilage (O-C) to the length of the SLIPA™ chamber. ⋯ Compared with the classic size-selection method, matching the width of the thyroid cartilage with that of the SLIPA™, the size-selection method of matching SLIPA™ chamber length to O-C for adult patients is more accurate.
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Journal of anesthesia · Aug 2013
Randomized Controlled TrialVigilance of hemodynamic changes immediately after transferring patients is crucial.
A decrease in blood pressure is sometimes observed when a postsurgical patient is transferred to another bed after recovering from anesthesia. However, the mechanism behind this hypotension has not been completely elucidated. The purpose of this study was to investigate and compare changes in hemodynamic properties for possible causes of hypotension before and after transfer to another bed of postsurgical patients receiving general anesthesia, combined epidural and general anesthesia, or combined spinal and general anesthesia. ⋯ The decrease in blood pressure observed after transfer of a postsurgical patient to another bed after general, combined epidural and general, and combined spinal and general anesthesia was associated with a decrease in CO and no change in SVR, but HR decreased after combined spinal and general anesthesia, whereas it was unchanged after general and combined epidural and general anesthesia. The decrease in blood pressure is assumed to be caused by a decrease in venous return, and several reflexes might participate in this decrease of blood pressure, especially after combined spinal and general anesthesia.