Acta anaesthesiologica Sinica
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Acta Anaesthesiol. Sin. · Dec 2002
Randomized Controlled Trial Clinical TrialOral clonidine reduces myocardial ischemia in patients with coronary artery disease undergoing noncardiac surgery.
To access the clinical effect of clonidine on reduction of myocardial ischemia events in patients with history of coronary artery disease undergoing noncardiac surgeries. ⋯ We conclude that premedication with oral clonidine can significantly reduce the incidence of perioperative myocardial ischemia in patients with CAD undergoing noncardiac surgeries. The incidence of myocardial ischemia in these patients is rather high during perioperative period, which deserves our exceptional caution.
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Acta Anaesthesiol. Sin. · Dec 2002
Randomized Controlled Trial Clinical TrialThe tracheal detecting-bulb: a new device to distinguish tracheal from esophageal intubation.
The tracheal detecting-bulb (TDB) is a diagnostic tool for confirmation of tracheal intubation. Capnography is also accepted as a standard way for such confirmation. The purpose of this investigation was to determine whether the results by TDB agreed with those by capnography. ⋯ The TDB is a valuable diagnostic technique for confirming tracheal intubation as it could correctly detect esophageal or tracheal intubation of the tracheal tube in all our 400 patients. The results of using TDB agree with the results of using capnography.
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The tussive effect of fentanyl, in sharp contrast to the antitussive effect that common opioids have, is not rarely seen in clinical anesthesia. Pretreatment with beta 2 agonist inhalation could dramatically suppress fentanyl-induced coughing. We hypothesized that airway hyperresponsiveness might exist in large proportion of the subjects who had experienced fentanyl-induced coughing during previous anesthesia. ⋯ From the analysis of the present study, we cannot prove that there is a direct correlation between fentanyl-induced coughing and airway hyperresponsiveness.
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Acta Anaesthesiol. Sin. · Dec 2002
Personnel exposure to waste sevoflurane and nitrous oxide during general anesthesia with cuffed endotracheal tube.
Waste anesthetic gases may have adverse effects on the health of operating room personnel. To reduce the risk of exposure, the United States National Institute of Occupational Safety and Health (US-NIOSH) recommends a time-weighted average (TWA) of 25 ppm (part-per-million) for nitrous oxide (N2O) and a ceiling of 2 ppm for sevoflurane (SEV). This study investigated the concentrations of these two gases in the atmosphere of operating room to which the working personnel (anesthetists) were exposed during anesthetic practice. ⋯ To decrease the exposure of the operating personnel to waste anesthetics, minimization of the use of N2O is recommended. Besides, the three extraordinary conditions as disclosed in this study were tubing flushing, illy managed endotracheal tube cuff and disconnection of scarvenging system, the first of which sometimes is unavoidable but the last two of which should be avoided.
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Acta Anaesthesiol. Sin. · Dec 2002
Randomized Controlled Trial Comparative Study Clinical TrialTracheal intubation condition--a comparison between one minute after rocuronium alone, one minute after rocuronium combined with atracurium and one minute after atracurium with rocuronium at one minute priming interval.
Rocuronium, a monoquaternary steroid analogue of vecuronium, is designed to provide a rapid onset of action. Experimentally, it has been shown that two non-depolarizing neuromuscular relaxants administered together can produce either a neuromuscular block of a size expected to be the sum of the individual doses (additive effect) or a larger neuromuscular block (synergistic effect). Experimental observations have suggested that during onset rocuronium acts synergistically with other nondepolarizing agents, but that at a steady state the combined action is additive. ⋯ Statistically, rocuronium alone, mixture of equipotent atracurium and rocuronium, and using rocuronium to prime atracurium all provided similar onset for satisfactory intubation.