British journal of anaesthesia
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Randomized Controlled Trial Comparative Study
Comparison of the effects of thoracic and lumbar epidural anaesthesia on induction and maintenance doses of propofol during total i.v. anaesthesia.
In this randomized, double-blind study, the effects of thoracic and lumbar epidural anaesthesia on the induction doses (IDs) and maintenance doses (MDs) of propofol during bispectral index (BIS) guided total i.v. anaesthesia were compared. ⋯ Similar segments blocked with epidural anaesthesia have resulted in similar ID. During maintenance, identical amounts of bupivacaine applied from different levels have resulted in different MD of propofol. The concentration of the epidural anaesthesia appears to play a more important role than the applied amount of the local anaesthetic.
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Clinical Trial
Propofol-based sedation regimen for infants and children undergoing ambulatory magnetic resonance imaging.
Propofol is widely used for infants and children requiring sedation for magnetic resonance imaging. However, increased doses of propofol may quickly lead to an unintended deep sedation and respiratory depression. Thus, an appropriate low dosage, which nevertheless ensures sufficient sleep for successful magnetic resonance imaging (MRI) completion, would probably minimize respiratory adverse events. We investigated the safety and efficacy of a low-dose propofol-based sedation regimen in a broad age range of children. ⋯ This sedation regimen provides the shortest induction time so far described, a rare demand for additional sedation, a low incidence of respiratory events, and a rapid recovery.
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Comparative Study
Comparison of central venous and external jugular venous pressures during repair of proximal femoral fracture.
External jugular venous pressure (EJVP) is a close estimate of central venous pressure (CVP) in patients undergoing mechanical ventilation in the supine position, but the effects of spontaneous respiration and posture on this relationship are not known. In this study, we compared CVP with EJVP measurements in 36 patients undergoing repair of proximal femoral fracture breathing spontaneously in the supine or lateral positions. ⋯ These data suggest that EJVP is an acceptable estimate of CVP in the supine position. Agreement was poor in the lateral position but was stronger for estimates of trend rather than absolute values. This could be explained by the direct effects of posture.
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There is a paucity of data regarding the coagulation status when discontinuing perineural catheters in patients receiving anticoagulant after operation. This retrospective study was designed to establish international normalized ratio (INR) and prothrombin time (PT) at the time of removal of lumbar plexus perineural catheters in patients receiving warfarin after total hip replacement. ⋯ Although in this retrospective analysis, we demonstrated that lumbar plexus catheters were removed with an INR > or =1.5, additional data are required to confirm the safety of such an approach.