Abstract:
STUDY OBJECTIVE:To determine the effects of fresh gas flow on inspired gas composition during low-flow anesthesia. DESIGN:Randomized trial with 2-hour observation periods in patients assigned to one of three groups. SETTING:Inpatient surgery clinic at a medical center. PATIENTS:Thirty-six patients undergoing abdominal surgery with low-flow anesthesia. INTERVENTIONS:Fresh gas flow was given at a starting rate of 5 L/min for 6 minutes. Thereafter, the fresh gas flow setting was nitrous oxide (N2O) 1 L/min and oxygen (O2) 0.6 L/min (Group 1), N2O 0.5 L/min and O2 0.5 L/min (Group 2), and with a moderate surplus of N2O and O2 with respect to the patient's O2 consumption (Group 3). MEASUREMENTS AND MAIN RESULTS:The inspired O2 concentration (FIO2) was measured using a paramagnetic technique, and N2O levels were measured with infrared sensors; the inspired nitrogen concentration (FIN2) was calculated by the following formula: FIN2 = 1-FIO2-FIN2O, where FIN2O is the inspired N2O concentration. After 1 hour of anesthesia, FIO2 was significantly lower in Group 1 than in Groups 2 and 3 (p < 0.01), and FIN2 was significantly higher in Groups 2 and 3 than in Group 1 (p < 0.01). After 2 hours of anesthesia, FIN2 returned to normal in Group 2 but continued to increase in Group 3. FIN2O was close to 0.7% only in Group 1. CONCLUSIONS:The same initial period of denitrogenation is not adequate to denitrogenate the circle system in all cases. The lower the fresh gas flow, the longer the initial period of denitrogenation should be. Various levels of fresh gas flow for low-flow anesthesia have been suggested, but none guarantees adequate control of inspired gas composition unless flowmeters are continuously adjusted.
journal_name
J Clin Anesthjournal_title
Journal of clinical anesthesiaauthors
Gregorini Pdoi
10.1016/0952-8180(92)90214-lsubject
Has Abstractpub_date
1992-11-01 00:00:00pages
439-43issue
6eissn
0952-8180issn
1873-4529pii
0952-8180(92)90214-Ljournal_volume
4pub_type
临床试验,杂志文章,随机对照试验abstract::The neurologic implications of diabetic hyperglycemia depend on whether the ischemic insult is permanent or temporary. Laboratory studies show that following permanent focal ischemia, a situation analogous to stroke, diabetic hyperglycemia is protective in the penumbral region, whereas it may slightly increase infarct...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,评审
doi:10.1016/s0952-8180(97)00021-4
更新日期:1997-06-01 00:00:00
abstract:STUDY OBJECTIVES:To test the hypothesis that for major gynecologic surgery the combination of propofol for induction, ondansetron, and dexamethasone would be a more effective antiemetic combination than propofol for induction, ondansetron, and saline; and to determine if a propofol induction of anesthesia improved our ...
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(96)00215-2
更新日期:1997-02-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the incidence and impact on clinical outcome of complications observed during high-frequency jet ventilation (HFJV) at interventional bronchoscopy and to identify the perioperative factors that may be associated to an increased incidence of such complications. DESIGN:Observational retrospec...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章
doi:10.1016/j.jclinane.2005.12.011
更新日期:2006-08-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate patient acceptability of continued versus divided anesthetic care. DESIGN:Patient satisfaction ratings with continuous and divided anesthetic care were assessed by patient questionnaire. In addition, the effect of training anesthesia personnel in communication regarding divided anesthesia c...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2006.04.004
更新日期:2007-02-01 00:00:00
abstract:STUDY OBJECTIVE:To understand anesthesiologists' and surgeons' risk attitudes about expected years of life. DESIGN:Prospective study. SETTING:Central operating rooms (ORs) in a university hospital. RESPONDENTS:122 anesthesiologists and surgeons. MEASUREMENTS AND MAIN RESULTS:A 7-page survey questionnaire regarding ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(00)00130-6
更新日期:2000-03-01 00:00:00
abstract:STUDY OBJECTIVE:Erector spinae plane (ESP) block is a novel regional anesthesia technique and gaining importance for postoperative pain management. Since it was first described, the clinicians wonder if this new simple technique can replace paravertebral block (PVB). We aimed to compare the postoperative analgesic effe...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2019.06.036
更新日期:2020-02-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the onset time, success rate, and recovery profile of unilateral spinal anesthesia produced with 4 mg, 6 mg, and 8 mg of 0.5% hyperbaric bupivacaine. DESIGN:Prospective, randomized, blinded study. SETTING:Outpatient anesthesia unit at a University Hospital. PATIENTS:90 ASA physical status...
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(03)00078-3
更新日期:2003-08-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate airway changes in patients undergoing surgery in the prone position. DESIGN:Single-arm observational study. PATIENTS:Patients between 18 to 65 years old, scheduled for prone spinal surgery; 74 patients were enrolled and 54 patients were analyzed. INTERVENTION:The initial airway examinatio...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2014.04.010
更新日期:2014-12-01 00:00:00
abstract::Obstructive sleep apnea (OSA) is associated with postoperative airway obstruction, hypoxemia, cardiac arrhythmias, cardiorespiratory arrest, hypoxic encephalopathy, and death. Three cases highlighting important issues in patients with OSA are presented that occurred prior to and after implementation of an OSA protocol...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2008.08.023
更新日期:2009-06-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the effect of clonidine when added to local anesthetics on duration of postoperative analgesia during retrobulbar block. DESIGN:Prospective, randomized controlled trial. SETTING:Operating room and Postanesthesia Care Unit of a university-affiliated hospital. SUBJECTS:80 ASA physical statu...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2010.12.014
更新日期:2011-08-01 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::During cataract surgery, both the surgeon and the anesthesiologist need access to the patient's face. At our institution we achieved a working compromise by using an oxygen insufflating hoop, which allowed the surgeon access to the eye and a sterile field. The patient's airway was kept free by the hoop, and the patien...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(89)90024-x
更新日期:1989-01-01 00:00:00
abstract:STUDY OBJECTIVES:To evaluate the effects of fentanyl on the cardiorespiratory system in elderly patients undergoing cataract surgery with phacoemulsification method. DESIGN:Randomized, prospective, double-blind study. SETTING:University hospital. PATIENTS:70 ASA physical status I, II, and III patients (>60 years) wh...
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/j.jclinane.2003.05.008
更新日期:2004-03-01 00:00:00
abstract:STUDY OBJECTIVE:Outpatient continuous interscalene brachial plexus blocks containing bupivacaine or ropivacaine are commonly used to control pain after shoulder surgery. Interscalene blocks cause hemidiaphragmatic paresis. Because ropivacaine preferentially blocks sensory fibers, it may cause less blockade of the phren...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2015.03.006
更新日期:2015-12-01 00:00:00
abstract::Visualization of thromboembolic material in the pulmonary artery is often difficult on transesophageal echocardiography, especially in the left pulmonary artery, because of the position of the left main bronchus. We present a case in which thromboembolic material within the midleft pulmonary artery was incidentally di...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2007.06.026
更新日期:2008-03-01 00:00:00
abstract:STUDY OBJECTIVE:To analyze the effects of epidural analgesia for labor when dystocia occurs. DESIGN:Retrospective cohort study. SETTING:Academic health center. PATIENTS:641 low risk, nulliparous women in spontaneous labor. INTERVENTIONS:406 (63%) women received epidurals analgesia and 253 (37%) did not. Sixty women...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章
doi:10.1016/s0952-8180(97)00222-5
更新日期:1998-02-01 00:00:00
abstract:STUDY OBJECTIVE:Dexmedetomidine, a highly selective α2-receptor agonist, has been widely used for protection against ischemia-reperfusion (IR) injury. We hypothesized that dexmedetomidine might exert a protective effect on IR injury after hepatectomy. DESIGN:A prospective, randomized, single-blind study was conducted ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2019.109631
更新日期:2020-05-01 00:00:00
abstract::Substance abuse is the most serious occupational safety issue associated with the practice of anesthesiology, with an incidence as high as 1% per year of training. The Cleveland Clinic's Anesthesiology Institute approached the process from the perspective of active prevention, including specific mandatory education pr...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2008.12.030
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVE:The American Society of Anesthesiologists physical status (ASA-PS) is associated with increased morbidity and mortality in the perioperative period. When surgeries are scheduled by surgeons and their staff at our large institution a presumed ASA-PS is chosen. This is because our institution (and, anecdotally,...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2017.02.002
更新日期:2017-05-01 00:00:00
abstract:STUDY OBJECTIVE:To establish a useful ultrasonic approach to the epidural space so as to optimize pre-puncture diagnostics. DESIGN:Prospective study. SETTING:University clinic. PATIENTS:60 participants (19 to 34 years of age), 40 healthy volunteers (20 male, 20 female) and 20 parturients. INTERVENTIONS:Ultrasound s...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章
doi:10.1016/s0952-8180(01)00245-8
更新日期:2001-05-01 00:00:00
abstract::A 13-year-old girl with Goltz's (Goltz-Gorlin) syndrome (focal dermal hypoplasia) and cloacal exstrophy underwent day surgery cystoscopy. During the administration of inhalation anesthesia by mask, persistent partial upper airway obstruction was noted. Direct laryngoscopy unexpectedly showed variously sized verrucous ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(91)90190-x
更新日期:1991-09-01 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:To evaluate the profile of molecular hemostatic markers in patients receiving either spinal or balanced general anesthesia for total hip arthroplasty. DESIGN:Open, randomized, observational study. SETTING:Orthopedic unit and central laboratory of a university hospital. PATIENTS:26 consenting ASA phys...
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(03)00082-5
更新日期:2003-09-01 00:00:00
abstract::A 69-year-old male with severe coronary artery disease, ankylosing spondylitis, and severe major depression was scheduled for electroconvulsive therapy (ECT). The patient had previously failed or proved intolerant of antidepressant drug therapy. The nature and severity of the patient's diseases and complexity of poten...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(92)90071-8
更新日期:1992-05-01 00:00:00
abstract::The initial written examination of the American Board of Anesthesiology, a division of the American Board of Surgery, was given on March 28, 1939. For all anesthesiologists, this date has double significance. First, what was meant by anesthesiology as a medical specialty was defined through the questions posed on the ...
journal_title:Journal of clinical anesthesia
pub_type: 历史文章,杂志文章
doi:10.1016/0952-8180(92)90226-q
更新日期:1992-11-01 00:00:00
abstract:STUDY OBJECTIVES:To determine alfentanil levels with a specific radioimmunoassay in serum and ovarian follicular fluid. DESIGN:Observational study. SETTING:University hospital. PATIENTS:14 ASA status I women undergoing oocyte retrieval for in vitro fertilization. INTERVENTIONS:General anesthesia was induced with al...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章
doi:10.1016/0952-8180(96)00035-9
更新日期:1996-06-01 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 OBJECTIVE:To examine perioperative management and complications in patients undergoing pneumonectomy. DESIGN:Observational cohort study. SETTING:University-affiliated city hospital. MEASUREMENTS:65 patients who underwent unilateral pneumonectomy for resection of lung cancer between March 1997 and October 2007 ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2009.02.013
更新日期:2010-02-01 00:00:00
abstract::The right heart and great veins can be the harbinger of septic and aseptic thromboemboli, which can result in a spectrum of clinical syndromes. This report presents five distinct clinical scenarios of thromboembolization, the occurrence of which in the central circulation resulted in life-threatening sepsis and hemody...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,评审
doi:10.1016/0952-8180(93)90071-l
更新日期:1993-11-01 00:00:00
abstract:STUDY OBJECTIVES:To assess whether the year of residency in anesthesiology is associated with residents' overall perceptions of the learning environment and to evaluate the association between year of residency and each of the five domains of the Dundee Ready Education Environment Measure (DREEM) survey. DESIGN:Cross-...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2016.09.017
更新日期:2016-12-01 00:00:00