Articles: patients.
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Most emergency departments (EDs) have deficiencies in the type and quantity of antidotes readily available to treat severely poisoned patients. Undue emphasis on the purchase price of several expensive antidotes such as anti-digoxin F(ab) fragments and fomepizole may contribute to this problem by creating the perception that comprehensive antidote stocking is too costly for smaller centres. For rarely used medications, however, purchase price alone is an insufficient estimate of cost. ⋯ While other factors (antidote efficacy, safety and available alternate therapy) need to be considered, the cost of maintaining antidote availability is not determined primarily by purchase price. A change in supplier policy to free replacement on expiry for fomepizole and cyanide antidotes would have a considerable effect on making these antidotes less costly for smaller Canadian EDs.
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Journal of anesthesia · Jan 2002
Randomized Controlled Trial Clinical TrialComparative effect of 6% hydroxyethyl starch (containing 1% dextrose) and lactated Ringer's solution for cesarean section under spinal anesthesia.
This study aimed to compare low-molecular weight hydroxyethyl starch containing 1% dextrose (HES) infusion and lactated Ringer's solution (LR) in the prevention of hypotension associated with spinal anesthesia for cesarean section. ⋯ This study did not show an advantage of HES compared with LR in the prevention of hypotension or in the reduction of ephedrine dose during cesarean section under spinal anesthesia. The anesthesia level, rather than the choice of intravenous fluid solution, might be related to the ephedrine dose.
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Journal of anesthesia · Jan 2002
Onset of vecuronium-induced neuromuscular block after a long priming interval.
We examined whether a new application of the priming principle, i.e., having the priming dose of vecuronium administered before the insertion of the epidural catheter, would hasten the onset of the neuromuscular block induced by the intubating dose of vecuronium. ⋯ If the priming dose of vecuronium is given after a long priming interval (16 +/- 3 min), the time to onset of the neuromuscular block caused by the intubating dose of vecuronium is markedly shorter than when the conventional priming interval of 4 min is employed.
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Journal of anesthesia · Jan 2002
Randomized Controlled Trial Clinical TrialThe effect of propofol infusion on minimum alveolar concentration of sevoflurane for smooth tracheal intubation.
This study was conducted to determine the effect of propofol infusion on the minimum alveolar concentration necessary for smooth tracheal intubation (MACEI) of sevoflurane. ⋯ Propofol infusion reduced sevoflurane MACEI. This finding suggests that propofol would be an excellent adjuvant to use with sevoflurane for tracheal intubation.
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Journal of anesthesia · Jan 2002
Multiple-deep-breath inhalation induction with 5% sevoflurane and 67% nitrous oxide: comparison with intravenous injection of propofol.
To evaluate the clinical characteristics of multiple-deep-breath inhalation induction with sevoflurane and nitrous oxide followed by the same inhalational anesthetics for maintenance, we compared the technique with intravenous propofol anesthesia. ⋯ Multiple-deep-breath inhalation induction with 5% sevoflurane and 67% nitrous oxide followed by the same inhalational anesthetics for maintenance was safely performed without serious adverse events. However, the induction time was shorter and patient satisfaction was higher in propofol group than in the inhalational group.