Anesthesia, essays and researches
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Epidural volume extension (EVE) is claimed to increase the block height and decrease the dose requirement for intrathecal drug. However, almost all studies have been done in obstetric population and none actually compares the effect of additional drugs added to epidural volume. ⋯ EVE can increase the block height significantly, but it seems to be limited only to the physical property of additional volume in epidural space and fentanyl or tramadol do not seem to differ in their ability to alter block properties.
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Daily interruption of sedation could minimize the problem of sedatives accumulation. Nevertheless, whatever is the sedation strategy; sedation, particularly deep levels, has been associated with high frequency of patient-ventilator asynchrony. Extending these findings, one would expect that no sedation protocol could reduce the frequency of patient-ventilator asynchrony. ⋯ No sedation protocol reduces the asynchrony index and preserves the patient's effort during triggering.
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To evaluate the efficacy of lidocaine patch applied around wound in laparoscopic colorectal surgery in reduction of postoperative pain and illus compared to intravenous lidocaine infusion and placebo. ⋯ The lidocaine patch was equal to i.v. lidocaine infusion in decreasing pain scores and morphine consumption but not in acceleration of bowel function return.
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The newest variation of the i-gel supraglottic airway is a pediatric version. ⋯ Hemodynamic parameters, ease of insertion, and postoperative complications were comparable between the i-gel and cLMA groups, but airway sealing pressure was significantly higher in i-gel group.
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Axillary brachial plexus block for below elbow orthopedic surgery provides a safe and low-cost technique with the advantage of prolonged postoperative analgesia. Clonidine, with selective partial agonist activity on α2 adrenergic receptors, has significantly demonstrated its role in this regard as an adjuvant to local anesthetics. The current study compares the locally administered clonidine with systemically administered control group in terms of onset and duration of sensory block, motor block, and analgesia; hemodynamic variability; sedation; and other side effect profile. ⋯ Compared to systemic administration, local clonidine as an adjuvant in axillary block resulted in significant prolongation of duration of sensory and motor blockade, and analgesia without any hemodynamic alteration, probably by locally mediated mechanism of action.