Acta anaesthesiologica Sinica
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Acta Anaesthesiol. Sin. · Sep 2002
Randomized Controlled Trial Comparative Study Clinical TrialThe macroscopic changes of tracheal mucosa following tight versus loose control of tracheal tube cuff pressure.
Tracheal mucosal lesions have been reported following intubation anesthesia. This has been mostly attributed to improper cuff pressure leading to ischemic damages of the tracheal mucosa. In this study macroscopic changes of tracheal mucosa at the site of cuff inflation were evaluated endoscopically after "tight method" of cuff pressure control using a special water manometer. ⋯ Tight control of cuff pressure can minimize the incidence and severity of macroscopic lesions of tracheal mucosa at the site of cuff inflation.
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Acta Anaesthesiol. Sin. · Sep 2002
Randomized Controlled Trial Clinical TrialCardiac output measurement during cardiac surgery: esophageal Doppler versus pulmonary artery catheter.
Bolus thermodilution cardiac output (BCO) measurement has been considered as the "gold standard" for cardiac output (CO) measurement. However, it requires placement of a pulmonary artery (PA) catheter, and questions have been raised regarding the risk/benefit ratio of this invasive technique. Furthermore, great variations between measurements have been reported. Continuous thermodilution CO (CCO) measurement is reported to be a better alternative, but it still requires the placement of a PA catheter. Esophageal echo-Doppler ultrasonography (ED) provides non-invasive continuous measurement of CO (ED-CO). This study was thus designed to compare the agreement between ED-CO and both thermodilution techniques (BCO and CCO). ⋯ Esophageal echo-Doppler ultrasonography is a satisfactory alternative for cardiac output measurement because it gives a value in good agreement with CCO measurement. With significant between-measurement variations, the accuracy and precision of BCO are uncertain, and it should not be considered as the "gold standard".
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Acta Anaesthesiol. Sin. · Sep 2002
Case ReportsLong-term opioid treatment in Behçet's syndrome with intractable abdominal pain--a case report.
Opioids are the most potent and effective analgesics available for treating acute and chronic cancer pain, but its usefulness in treating non-cancer chronic pain is still controversial. We report a 23-year-old male suffering from Behçet's disease with persistent excruciating abdominal pain. Oral non-steroid anti-inflammation analgesics and milder opioids (codeine and tramadol) failed to relieve the pain. ⋯ No sign of physical or psychological dependence was observed during the period of opiate administration, and no withdrawal phenomenon was found as the dosage was tapered. During the total treatment course of 213 days, the daily dose of morphine once surged up to 259.2 mg. The long-term opioid treatment and its possible effects are, herein, discussed.
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Endotracheal intubation using a laryngoscope is the most rapid and usually the easiest means to ensure a patent airway. It has therefore earned its popularity in anesthesia and other acute health care practices. However, intubation by conventional technique is not always successful as at times direct vision of the glottis/vocal cords is impossible during laryngoscopy. ⋯ This new technique works very well in our experiences. It can be performed quickly with readily available inexpensive equipment. Our favorable experience leads us to believe it is one of the most promising additions to the current recommended alternatives.