Journal of anaesthesiology, clinical pharmacology
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J Anaesthesiol Clin Pharmacol · Jan 2018
Intraoperative neurophysiological monitoring team's communiqué with anesthesia professionals.
Intraoperative neurophysiological monitoring (IONM) is the standard of care during many spinal, vascular, and intracranial surgeries. High-quality perioperative care requires the communication and cooperation of several multidisciplinary teams. One of these multidisciplinary services is intraoperative neuromonitoring (IONM), while other teams represent anesthesia and surgery. Few studies have investigated the IONM team's objective communication with anesthesia providers. We conducted a retrospective review of IONM-related quality assurance data to identify how changes in the evoked potentials observed during the surgery were communicated within our IONM-anesthesia team and determined the resulting qualitative outcomes. ⋯ Based on our institutions' protocol and algorithm for intervention during IONM-supported surgeries, our findings of resolution in alerts and notifications indicate that successful communications between the two teams could potentially lead to improved anesthetic care and patient safety.
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J Anaesthesiol Clin Pharmacol · Jan 2018
Comparison of ropivacaine (0.2%) with or without clonidine 1 μg/kg for epidural labor analgesia: A randomized controlled study.
The aim is to determine the effect of addition of clonidine to ropivacaine for epidural labor analgesia with regard to onset of analgesia, duration of analgesia, neonatal outcome, and quality of analgesia. ⋯ We conclude that clonidine in low doses is a useful adjuvant to local anesthetics for epidural labor analgesia and a good alternative to opioids.
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J Anaesthesiol Clin Pharmacol · Jan 2018
Predicting endotracheal tube size from length: Evaluation of the Broselow tape in Indian children.
Several formulae are available to estimate endotracheal tube (ETT) size in children. This study was designed to compare the ETT estimated by the Broselow tape (BT) with age-based estimation of ETT size and to identify the most accurate formula for the prediction of uncuffed ETT size in Indian children. ⋯ Length of the child has a good correlation with size of the ETT to be used in Indian children across all age groups. BT is an effective tool to predict ETT size in children >6 months.
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J Anaesthesiol Clin Pharmacol · Jan 2018
Evaluation of dexmedetomidine and fentanyl as additives to ropivacaine for epidural anesthesia and postoperative analgesia.
The synergism between epidural local anesthetic agent and opioids is well established, but evidence for the combination of local anesthetic agent with dexmedetomidine in epidurals is limited. This study evaluates the clinical efficacy of dexmedetomidine versus fentanyl as an additive to ropivacaine for epidural anesthesia. ⋯ Epidural anesthesia achieved with 10 μg dexmedetomidine as an additive to 0.5% ropivacaine is more effective with respect to duration and intensity of analgesia when compared to 0.5% ropivacaine alone or addition of 20 μg fentanyl to 0.5% ropivacaine.
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J Anaesthesiol Clin Pharmacol · Jan 2018
Effectiveness of Proseal laryngeal mask airway and laryngeal tube suction in elective non-laparoscopic surgeries of up to ninety minutes duration: A prospective, randomized study.
Proseal laryngeal mask airway (LMA) and laryngeal tube suction (LTS) are both supraglottic devices with an esophageal suction port. In the present prospective, randomized study, the effectiveness of airway seal, hemodynamic variables, ability to pass orogastric tube, and postoperative complications with the two devices were evaluated. ⋯ Both Proseal LMA and LTS were acceptable alternatives for airway management in elective surgeries with controlled ventilation, but the quality of ventilation was found to be significantly better with Proseal LMA (in terms of higher seal pressure, lesser peak pressure, lesser insertion time, and lesser complications).