Journal of anesthesia
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Journal of anesthesia · Dec 2011
Randomized Controlled TrialAmino acid infusions started after development of intraoperative core hypothermia do not affect rewarming but reduce the incidence of postoperative shivering during major abdominal surgery: a randomized trial.
Previous studies have demonstrated that amino acid infusions exert enhanced thermogenic effects during general anesthesia. This study was conducted to investigate whether amino acid infusions started after development of intraoperative core hypothermia can accelerate rewarming. ⋯ Amino acid infusions started after development of intraoperative core hypothermia failed to accelerate rewarming. However, amino acid infusions reduced the incidence of postoperative shivering. Use of amino acid infusions to reduce thermoregulatory vasoconstriction at emergence might contribute to a decrease in the development of postoperative shivering.
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Journal of anesthesia · Dec 2011
Randomized Controlled TrialRetrospective analysis of spontaneous recovery from neuromuscular blockade produced by empirical use of rocuronium.
A train-of-four ratio (TOF ratio) of >0.9 should be the clinical cut-off to avoid residual paralysis. However, it is not rare to extubate patients without measurement of the TOF ratio, although the safe interval from the last administration of rocuronium assuring a TOF ratio of >0.9 has not been established in the daily clinical setting. In this study, to estimate the safe interval to avoid residual paralysis, we retrospectively selected patients in whom the TOF ratio was measured during remifentanil administration before extubation, and we studied the characteristics of recovery from the neuromuscular blockade produced by the empirical use of rocuronium. ⋯ Because of the large variation in the recovery from rocuronium-induced paralysis, TOF-based evaluation of residual paralysis is essential to determine the appropriate indication for reversal, especially for elderly patients.
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Journal of anesthesia · Dec 2011
Randomized Controlled TrialSevoflurane to alleviate pain on propofol injection.
Since the introduction of propofol, several drugs and methods have been used to alleviate the pain on its injection. This study was designed to evaluate the effect of adding sevoflurane 3% during preoxygenation in alleviation of pain on propofol injection. ⋯ The addition of 3% sevoflurane at the time of preoxygenation for 1 min along with routine use of lidocaine-tourniquet completely prevented pain upon propofol injection, whereas sevoflurane by itself provided similar analgesia to premixed lidocaine with propofol.
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Journal of anesthesia · Dec 2011
Randomized Controlled TrialEffects of adjunct intrathecal magnesium sulfate to bupivacaine for spinal anesthesia: a randomized, double-blind trial in patients undergoing lower extremity surgery.
The aim of this study was to evaluate the effect of additional magnesium sulfate (MgSO(4)) 100 mg to intrathecal (IT) isobaric 0.5% bupivacaine 3 ml on spinal anesthesia in patients undergoing lower extremity orthopedic surgery. ⋯ In patients undergoing lower extremity surgery with spinal anesthesia, the addition of 100 mg IT MgSO(4) to 15 mg bupivacaine without opioid supplement, prolonged the duration of the sensory block, decreased postoperative analgesic consumption, and significantly prolonged the onset of spinal anesthesia.
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Journal of anesthesia · Dec 2011
Randomized Controlled TrialPerioperative infusion of dexmedetomidine at a high dose reduces postoperative analgesic requirements: a randomized control trial.
We hypothesized that a high dose of dexmedetomidine (1 μg/kg/h) could reduce postoperative analgesic requirements of patients. ⋯ Among this small patient cohort, perioperative infusion of dexmedetomidine (1 μg/kg/h) resulted in antinociception without severe side effects. These results suggest that this method could be of interest with respect to improving postoperative pain status.