Journal of anesthesia
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Journal of anesthesia · Aug 2012
Randomized Controlled TrialThe effect of dexmedetomidine on arterial-cardiac baroreflex function assessed by spectral and transfer function analysis.
The α(2)-adrenergic receptor agonist dexmedetomidine reportedly weakens heart rate (HR) responses to 'rapid' (during a few seconds) reduction in arterial pressure, but does not affect HR responses to 'gradual' (during 60 s) reduction in arterial pressure. As the speed of neurotransmission along the parasympathetic nerve is relatively rapid, alteration of parasympathetic-mediated arterial-cardiac baroreflex function plays a more important role in HR responses to 'rapid' changes in arterial pressure. We therefore hypothesized that dexmedetomidine attenuates parasympathetic-mediated arterial-cardiac baroreflex function. ⋯ The present results suggest that dexmedetomidine attenuates parasympathetic-mediated arterial-cardiac baroreflex function, implying weakened HR response to 'rapid' reduction in arterial pressure.
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Journal of anesthesia · Aug 2012
Randomized Controlled TrialFlurbiprofen axetil provides a prophylactic benefit against mesenteric traction syndrome associated with remifentanil infusion during laparotomy.
Mesenteric traction syndrome (MTS) is caused by PGI(2) release during abdominal procedures and is often observed during abdominal surgery. We have demonstrated that MTS occurs more frequently in cases using remifentanil than in those that are not. The aim of this study was to assess the prophylactic benefit of flurbiprofen axetil on MTS in patients undergoing abdominal surgery using remifentanil. ⋯ We found that preoperative administration of flurbiprofen axetil reduced the incidence of MTS during abdominal surgery with remifentanil analgesia.
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Journal of anesthesia · Aug 2012
Randomized Controlled TrialKetofol in electroconvulsive therapy anesthesia: two stones for one bird.
Propofol and ketamine have become progressively popular in electroconvulsive therapy (ECT) anesthesia, although propofol shortened seizure duration and ketamine might cause cardiotoxicity, psychotic episodes, and delayed recovery. Ketofol is a combination of ketamine and propofol, and the current study was designed to evaluate the effect of ketamine, propofol, and ketofol on hemodynamic profile, duration of seizure activity, and recovery times in patients undergoing ECT. ⋯ The ketofol 1:1 mixture is associated with longer mean seizure time than propofol, and shorter mean recovery times than ketamine, with better hemodynamic stability, without any important side effects in ECT anesthesia.
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Journal of anesthesia · Aug 2012
Randomized Controlled Trial Comparative StudyEfficacy of Coopdech videolaryngoscope: comparisons with a Macintosh laryngoscope and the Airway Scope in a manikin with difficult airways.
We studied the efficacy of the Coopdech videolaryngoscope Portable VLP-100, by comparing it with a Macintosh laryngoscope, and another videolaryngoscope, the Airway Scope (AWS), in a manikin with four simulated difficult airways. In a randomized, crossover design, each of 50 residents inserted the three devices, in turn, and graded the view of the glottis at laryngoscopy. Time to see the glottis, time to intubate the trachea, and the success rate of tracheal intubation (within 120 s) were recorded. ⋯ In a manikin with cervical spine rigidity or pharyngeal obstruction, the AWS and the VLP-100 provided significantly higher success rates of intubation than the Macintosh laryngoscope (P < 0.05). In a manikin with laryngospasm, no one could intubate the trachea using any device. Our results indicate that, in patients with difficult airways, the videolaryngoscopes (VLP-100 and AWS) would provide higher success rates of tracheal intubation than the Macintosh laryngoscope, but the VLP-100 may be inferior to the AWS.
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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.