Abstract:
STUDY OBJECTIVE:To compare emergence from anesthesia and the hemodynamic and respiratory depressant effects of thiopental sodium infusion plus sufentanil or fentanyl with those of isoflurane as the primary component of a balanced technique for neuroanesthesia. DESIGN:Randomized, double-blind, prospective study. SETTING:University hospital and its affiliated Veterans Affairs Medical Center. PATIENTS:Thirty patients undergoing elective craniotomy for aneurysm or tumor. INTERVENTIONS:Thiopental with infusion of sufentanil 0.1 microgram/kg/hr, thiopental with infusion of fentanyl 1 microgram/kg/hr, or inhalation of 0.25% to 2% isoflurane as the major component of a balanced anesthesia technique that included nitrous oxide (N2O) and vecuronium (potency ratio of sufentanil to fentanyl, 10:1). MEASUREMENTS AND MAIN RESULTS:Intraoperative stress response (as indicated by intraoperative hypertension) was said to be the percentage of time the patient required administration of an antihypertensive drug, measuring from the first dose of thiopental to discontinuation of N2O at the end of the procedure, excluding any period of induced hypotension. Rapidity of emergence was measured by the number of minutes from discontinuation of N2O to first opening of the eyes on command. Adequacy of spontaneous ventilation was evaluated by determining partial pressure of arterial carbon dioxide 1, 2, and 3 hours after discontinuation of N2O. Extent of vasoactive drug administration for control of intraoperative hypertension (as determined by the clinicians caring for the patients) was described by minutes of vasodilator infusion and milligrams of propranolol or labetalol administered. The frequency of postoperative hypertension was defined as the number of patients in each group who required medication for postoperative hypertension. No significant differences in variables were found for thiopental/sufentanil, thiopental/fentanyl, or isoflurane when these drugs were used with N2O and vecuronium. CONCLUSIONS:Any one of these balanced anesthetic techniques appears appropriate for craniotomy.
journal_name
J Clin Anesthjournal_title
Journal of clinical anesthesiaauthors
Grundy BL,Pashayan AG,Mahla ME,Shah BDdoi
10.1016/0952-8180(92)90158-wsubject
Has Abstractpub_date
1992-09-01 00:00:00pages
372-7issue
5eissn
0952-8180issn
1873-4529pii
0952-8180(92)90158-Wjournal_volume
4pub_type
临床试验,杂志文章,随机对照试验abstract::With the advent of safety needles to prevent inadvertent needle sticks in the operating room (OR), a potentially new issue has arisen. These needles may result in coring, or the shaving off of fragments of the rubber stopper, when the needle is pierced through the rubber stopper of the medication vial. These fragments...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2013.10.007
更新日期:2014-03-01 00:00:00
abstract:STUDY OBJECTIVE:To report the occurrence of pseudo-hypotension during posterior osteotomy for correction of kyphosis in patients with ankylosing spondylitis. DESIGN:Retrospective case series. SETTING:University-affiliated hospital. MEASUREMENTS:The records of 36 patients with ankylosing spondylitis, who had severe t...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2012.05.001
更新日期:2013-02-01 00:00:00
abstract:STUDY OBJECTIVES:To examine the effect of timing of an intravenous (i.v.) dose (intraoperative vs. postoperative) of ketorolac tromethamine on pain scores and overall outcome after total abdominal hysterectomy (TAH) and myomectomy. DESIGN:Prospective, randomized, placebo-controlled study. PATIENTS:248 ASA physical st...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0952-8180(97)00062-7
更新日期:1997-08-01 00:00:00
abstract:STUDY OBJECTIVES:To investigate the hypothesis that the combination of ondansetron and droperidol would be more effective than droperidol alone in reducing nausea and vomiting. DESIGN:Randomized, doubleblind study. SETTING:Magee-Womens Hospital, Pittsburgh, Pennsylvania. PATIENTS:160 healthy, ASA physical status I a...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0952-8180(97)00188-8
更新日期:1998-02-01 00:00:00
abstract:STUDY OBJECTIVE:Morbid obesity is associated with significant comorbidities. Desflurane has a low fat-blood solubility coefficient and may be better suited in this population to achieve a rapid emergence; however, sevoflurane has favorable cardiorespiratory properties that might also prove advantageous in the morbidly ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2004.12.015
更新日期:2005-09-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate and compare cardiovascular responses to a new method of orotracheal intubation incorporating TV monitoring, with conventional orotracheal intubation via rigid blade laryngoscopy. DESIGN:Prospective single-blind study. SETTING:Operating room of a medical college hospital. PATIENTS:90 ASA p...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0952-8180(00)00196-3
更新日期:2000-11-01 00:00:00
abstract:STUDY OBJECTIVE:To compare the effects of Truview PCD™ video laryngoscopy (TVL) and Macintosh blade direct laryngoscopy (MDL) on hemodynamic responses observed during laryngoscopy and orotracheal intubation conditions in geriatric patients. DESIGN:Randomized prospective study. SETTING:Operating room. PATIENTS:One hu...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2016.09.010
更新日期:2016-12-01 00:00:00
abstract::The American Society of Anesthesiologists, the Anesthesia Patient Safety Foundation, the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), and the Patient Safety and Quality Improvement Act of 2005 encourage anesthesiology departments to institute systematic improvements in patient safety, inc...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2008.09.010
更新日期:2009-08-01 00:00:00
abstract:STUDY OBJECTIVE:To compare the rate of epidural use before and after the implementation of nitrous oxide (N2O). DESIGN:Data were obtained from a nursing database of N2O usage and our obstetric anesthesia database. We compared 8 months before and 8 months after the introduction of N2O. It was available 24 h/d, 7 d/wk, ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2016.07.019
更新日期:2016-12-01 00:00:00
abstract:STUDY OBJECTIVE:To describe our systematic approach to securing the airway in patients with laryngeal tumors, developed over a 10-year period. DESIGN:Retrospective analysis. SETTING:University-affiliated veterans administration medical center. PATIENTS:Eight hundred one patients presenting for laryngeal tumor surger...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2004.12.019
更新日期:2005-12-01 00:00:00
abstract::Brugada syndrome is an electrical cardiac disease predisposing to ventricular arrhythmias in which typical electrocardiographic (ECG) features consist of nonischemic repolarization abnormalities in the right precordial leads V1-V3. The appearance of a Brugada-ECG pattern is increasingly observed in critically ill pati...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2013.02.012
更新日期:2013-09-01 00:00:00
abstract::Hemodynamic instability as a result of altered baroreflex mechanism is common in surgeries involving manipulation around the carotid sheath. We report a case in which hypertensive crisis was associated with laryngectomy during general anesthesia. Perioperative use of vasoactive agents such as alpha(2) agonists may hel...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2006.12.011
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:Intraoperative remifentanil has been associated with postoperative hyperalgesia, higher visual analogic pain scores, and increased postoperative morphine consumption. However, this has not been investigated from patient's perspective by using a patient-reported outcomes (PROs) approach with a validated quest...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jclinane.2015.12.025
更新日期:2016-06-01 00:00:00
abstract::A 21 year old healthy parturient was diagnosed as having a fetus with micrognathia. She was scheduled for an ex-utero intrapartum treatment (EXIT) procedure. General anesthesia consisted of remifentanil, nitrous oxide, and midazolam. Intravenous nitroglycerin was used for uterine relaxation. This technique offered hem...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2009.12.014
更新日期:2011-03-01 00:00:00
abstract:STUDY OBJECTIVE:Medical residents working overnight call shifts experience sleep deprivation and circadian clock disruption. This leads to deficits in sensorimotor function and increases in workplace accidents. Using quick tablet-based tasks, we investigate whether measureable executive function differences exist follo...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2017.04.002
更新日期:2017-08-01 00:00:00
abstract:STUDY OBJECTIVE:To identify the maximally effective dolasetron dose (i.e., maximum efficacy with minimum adverse events) for prevention of postoperative nausea and vomiting (PONV) using the statistical power generated in a pooled patient sample from three large, nearly identical clinical trials. DESIGN:Three randomize...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0952-8180(99)00123-3
更新日期:2000-02-01 00:00:00
abstract::Transurethral vaporization of the prostate is a new method of electrosurgery used for treating benign prostatic hypertrophy. We observed simultaneous obturator nerve stimulation during spinal anesthesia while the middle lobe of the prostate was being resected. A discussion of why electrovaporization is different from ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(98)00069-5
更新日期:1998-09-01 00:00:00
abstract:STUDY OBJECTIVE:The aim of the study was to compare the incidence of the use of additional uterotonics before and after the change of carbetocin to oxytocin for the prevention of postpartum hemorrhage after cesarean delivery in women with severe preeclampsia. DESIGN:This was an observational retrospective before-and-a...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2016.08.017
更新日期:2016-12-01 00:00:00
abstract::We report the use of high-frequency oscillatory ventilation in the operating room during repair of multiple bronchopleural fistulae in a 9-year-old boy. In addition, we used principles of permissive hypercapnia to further minimize barotrauma. There were no cardiovascular consequences due to either the high-frequency v...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/S0952-8180(96)00206-1
更新日期:1997-02-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the significance of pain and other symptoms on the recovery process after ambulatory surgery, by surveying pain, analgesic use, and related aspects of recovery in the first 48 hours after discharge from an ambulatory surgery unit. DESIGN:Prospective, observational, surveillance survey. PA...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2003.08.004
更新日期:2004-05-01 00:00:00
abstract:STUDY OBJECTIVE:To compare analgesia and opioid-related side effects of intrathecal morphine and intrathecal hydromorphone after elective Cesarean delivery. DESIGN:Retrospective, comparative study. SETTING:Labor and delivery unit of an academic hospital. PATIENTS:114 parturients age ≥ 18 years, presenting for electi...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2013.01.014
更新日期:2013-08-01 00:00:00
abstract::We investigate an incident in which a carbon dioxide absorber caused difficulty with ventilation. The problem as it developed throughout the anesthetic, and clues that led to the determination that the carbon dioxide canister was the problem, is discussed. ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2007.06.018
更新日期:2008-02-01 00:00:00
abstract:STUDY OBJECTIVE:To ascertain patients' recall of the risks of labor epidural analgesia from a discussion of informed consent during active labor. DESIGN:Survey analysis following an intervention. SETTING:Labor and delivery unit of a tertiary-care teaching hospital. PATIENTS:101 ASA physical status I and II parturien...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章
doi:10.1016/s0952-8180(97)00258-4
更新日期:1998-03-01 00:00:00
abstract:STUDY OBJECTIVE:Our hypothesis was that a pre-operative posteromedial quadratus lumborum (QL) block would reduce postoperative morphine consumption and provide superior analgesia in the setting of multimodal analgesia compared with a lateral transversus abdominis plane (TAP) block for laparoscopic colorectal surgery. ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2020.109716
更新日期:2020-06-01 00:00:00
abstract:STUDY OBJECTIVES:To evaluate if using regional anesthesia for post-operative pain control for patients who underwent ankle ORIF is associated with a decrease in length of stay. DESIGN:Multicenter retrospective cohort study. SETTING:Inpatient perioperative. PATIENTS:12,468 inpatients (2007 to 2016) who received ankle...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2020.110008
更新日期:2020-12-01 00:00:00
abstract:STUDY OBJECTIVE:To study patients' requirement for propofol dosages during the course of repeated deep sedation for electroconvulsive therapy (ECT). DESIGN:Prospective study. SETTING:Outpatient psychiatric clinic in a tertiary-care, university-affiliated, 1100-bed metropolitan hospital. PATIENTS:30 patients undergoi...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章
doi:10.1016/j.jclinane.2003.09.009
更新日期:2004-06-01 00:00:00
abstract:STUDY OBJECTIVE:To compare the efficacy of patient-controlled analgesia (PCA) to physician-controlled analgesia in patients undergoing extracorporeal shock wave lithotripsy (ESWL). DESIGN:Prospective, randomized trial. SETTING:New Jersey Kidney Stone Treatment Center at Robert Wood Johnson University Hospital, New Br...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0952-8180(95)00008-6
更新日期:1995-05-01 00:00:00
abstract:STUDY OBJECTIVE:Lambert-Eaton myasthenic syndrome (LEMS) is an autoimmune disorder of the neuromuscular junction that manifests with muscle weakness, autonomic and bulbar dysfunction, and increased sensitivity to neuromuscular blocking drugs. The objective of this study is to review perioperative outcomes on a series o...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2014.09.009
更新日期:2014-12-01 00:00:00
abstract:STUDY OBJECTIVE:To survey graduates from our residency program to determine their involvement and their interest in becoming certified in neonatal resuscitation. DESIGN:Survey questionnaire. SETTING:Graduates from the University of Pennsylvania Anesthesia Program between 1989 and 1999. SUBJECTS:212 individuals compl...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(01)00285-9
更新日期:2001-08-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the methods used to teach surgical airway management to residents. DESIGN:Electronic mail survey instrument. SETTING:Academic medical center. PARTICIPANTS:82 (of a possible 132) United States residency program directors. MEASUREMENTS:Data including whether instruction in surgical airway...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2010.10.002
更新日期:2011-06-01 00:00:00