Journal of anesthesia
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Journal of anesthesia · Jan 2005
Case ReportsLow-dose vasopressin infusion in patients with severe vasodilatory hypotension after prolonged hemorrhage during general anesthesia.
We report the successful use of a low-dose vasopressin (VP) infusion to recover a hypotensive crisis in patients who suffered persistent hypotension after prolonged hemorrhage during general anesthesia. VP was infused in two posthemorrhagic vasodilatory shock patients when they remained persistently hypotensive despite adequate fluid resuscitation and infusions of pharmacological doses of catecholamines. ⋯ No adverse cardiac effects were observed during VP infusions in these patients. During vasodilatory shock after prolonged and severe hemorrhage, VP seems to be effective in reversing hypotension and decreasing the need for exogenous cathecholamines while preserving cardiac function and critical organ blood flow.
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Journal of anesthesia · Jan 2004
Randomized Controlled Trial Clinical TrialEfficacy of prophylactic intravenous granisetron in postoperative emesis in adults.
This randomized, double-blind, placebo-controlled trial evaluated the efficacy, safety, and optimal dose of granisetron in the prophylactic control of postoperative nausea and vomiting in patients undergoing gynecologic surgery or cholecystectomy. ⋯ Granisetron is well-tolerated and more effective than placebo in the prophylactic control of nausea and vomiting after surgery. This study suggests that the optimum dose of granisetron is 1 mg.
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Journal of anesthesia · Jan 2004
Randomized Controlled Trial Clinical Trial Controlled Clinical TrialRopivacaine produces sensory blockade in the lumbar sacral region more frequently than mepivacaine in lower thoracic epidural anesthesia.
The first sacral nerve has the largest diameter among the spinal nerves and is resistant to local anesthetics. Ropivacaine is a newly developed local anesthetic. There is a possibility that a difference in chemical properties between ropivacaine and other local anesthetics produces a difference in the blockade of the S1 dermatome by lower thoracic epidural anesthesia. Mepivacaine, 2%, is frequently used for epidural anesthesia and produces a level of blockade similar to that of bupivacaine, 0.5%. The purpose of this study was to examine the sensory blockade in the sacral region induced by ropivacaine with that induced by mepivacaine administered in the lower thoracic epidural space. ⋯ Ropivacaine, 1%, administered in the lower thoracic epidural space, induces sensory blockade to cold and pinprick in the S1 dermatome more frequently than 2% mepivacaine.
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Journal of anesthesia · Jan 2004
Randomized Controlled Trial Comparative Study Clinical TrialComparison between a disposable and an electronic PCA device for labor epidural analgesia.
The aims of the present study were (1) to investigate if a disposable patient-controlled analgesia (PCA) device can be used for labor analgesia and (2) to evaluate the device by midwives and parturients. ⋯ The present results imply that the disposable PCA device can be an alternative to the electronic PCA device for labor analgesia.