Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 1996
Randomized Controlled Trial Comparative Study Clinical TrialContinuous infusion is superior to bolus doses with thoracic paravertebral blocks after thoracotomies.
This study was designed to determine whether a continuous thoracic paravertebral infusion of bupivacaine (continuous TPVI) offers a higher quality of analgesia than a bolus regimen after thoracotomy. ⋯ Results suggest that continuous TPVI provides better pain control than the bolus regimen after this kind of surgery.
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J. Cardiothorac. Vasc. Anesth. · Aug 1996
Randomized Controlled Trial Comparative Study Clinical TrialComparative effects of plain and epinephrine-containing bupivacaine on the hemodynamic response to cervical plexus anesthesia in patients undergoing carotid endarterectomy.
This study was designed to investigate whether the addition of epinephrine as a vasoconstrictor additive to local anesthetic affects the hemodynamic profile after cervical plexus block in patients presenting for carotid endarterectomy. ⋯ Concerning cervical plexus block with bupivacaine, the use of epinephrine is associated with an increase in heart rate consistent with a beta-adrenergic effect from systemic absorption of the epinephrine. An increase in systolic blood pressure independent of the use of epinephrine also occurs, but epinephrine appears to mitigate against an increase in diastolic blood pressure.
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J. Cardiothorac. Vasc. Anesth. · Aug 1996
Randomized Controlled Trial Clinical TrialEffects of positive end-expiratory pressure ventilation on splanchnic oxygenation in humans.
To examine the influence of positive end-expiratory pressure (PEEP) ventilation on splanchnic oxygenation and lactate production in humans without pulmonary disorders. ⋯ Ventilation with PEEP causes reductions in CO and MAP, resulting in a comparable impairment of systemic and splanchnic oxygen. The absence of changes in lactate concentrations indicates that a critical reduction in systemic and splanchnic oxygenation is unlikely during ventilation with low or high PEEP levels.
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J. Cardiothorac. Vasc. Anesth. · Aug 1996
Comparative StudyA comparison of the endobronchial segment of modern left-sided double-lumen tubes in anesthesia for bilateral sequential lung transplantation.
To compare a range of currently available left-sided double-lumen endotracheal tubes (DLTs) in order to demonstrate differences among them with respect to the length of the endobronchial segment. It is proposed that a tube with a short endobronchial segment is better suited to anesthesia under the conditions imposed by double sequential lung transplantation. ⋯ There exists marked variability in the length of the endobronchial segment of left-sided double-lumen tubes currently available. These differences may be significant in anesthesia for bilateral sequential lung transplantation.
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J. Cardiothorac. Vasc. Anesth. · Aug 1996
Positive end-expiratory pressure during one-lung ventilation improves oxygenation in patients with low arterial oxygen tensions.
The application of 10 cm H2O of positive end-expiratory pressure (PEEP10) to the ventilated lung during one-lung ventilation (OLV) has an unpredictable effect on PaO2. It was hypothesized that patients with a low PaO2 (< 80 mmHg) during OLV may benefit from application of PEEP. ⋯ In patients with a low PaO2 (< 80 mmHg) during OLV with F1O2 = 0.5, PaO2 is increased by the application of PEEP10. This maneuver may be useful in situations in which application of continuous positive airway pressure (CPAP) to the nonventilated lung is not possible.