Abstract:
STUDY OBJECTIVE:To compare the intraoperative effects and recovery characteristics when either midazolam or propofol was used for sedation during local or regional anesthesia. DESIGN:Open-label, randomized study with blinded observer assessing recovery data. SETTING:Outpatients undergoing elective surgical procedures under local or regional anesthesia at Stanford University Hospital, Stanford, California. PATIENTS:Sixty-eight consenting, unpremedicated ASA physical status I, II, or III patients. INTERVENTIONS:After achieving adequate analgesia with local anesthetic solutions, patients were administered a loading dose of either midazolam (4.2 +/- 1.4 mg) or propofol (69 +/- 23 mg) followed by a variable-rate maintenance infusion equal to 8.6 +/- 5.4 mg/h or 265 +/- 185 mg/h, respectively, to maintain a stable level of sedation during the operation. MEASUREMENTS AND MAIN RESULTS:Intraoperative assessments included level of sedation, as well as cardiovascular and respiratory status, at 1- to 5-minute intervals during the operation. Postoperatively, recovery of cognitive and psychomotor function was assessed using analog scales and the digit-symbol substitution test. The overall quality of intraoperative sedation was similar in the two sedative treatment groups. Although midazolam produced less pain on injection and more effective intraoperative amnesia, use of propofol was associated with less postoperative sedation, drowsiness, confusion, clumsiness, and amnesia, as well as more rapid recovery of cognitive function. However, discharge times were similar in the two sedative treatment groups. CONCLUSIONS:Propofol infusion is a clinically useful alternative to midazolam for sedation during ambulatory surgery under local or regional anesthesia.
journal_name
J Clin Anesthjournal_title
Journal of clinical anesthesiaauthors
White PF,Negus JBdoi
10.1016/0952-8180(91)90203-ysubject
Has Abstractpub_date
1991-01-01 00:00:00pages
32-9issue
1eissn
0952-8180issn
1873-4529pii
0952-8180(91)90203-Yjournal_volume
3pub_type
临床试验,杂志文章,随机对照试验abstract::Presented here is a case of unilateral pulmonary edema following acute subglottic edema after removal of an endotracheal tube. A 3-year-old boy, diagnosed as having nondiphtheric croup and pectus excavatum deformity, was scheduled for repair of a cleft lip. No complication occurred during the operation. After removal ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(90)90049-9
更新日期:1990-01-01 00:00:00
abstract:STUDY OBJECTIVE:To correlate tracheal width as measured by ultrasound with width measured by computed tomography (CT), and to evaluate the possible role of ultrasound in the selection of the proper size of left-sided double-lumen endotracheal tubes (LDLTs). DESIGN:Two independent, prospective, observational clinical s...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2007.11.002
更新日期:2008-06-01 00:00:00
abstract::A 3-year-old girl presented for routine closure of her tracheostomy site. She was intubated easily for the procedure, and the wound was closed with a drain in place. In recovery, the mother noticed fullness in the patient's submandibular region, and on examination, the girl had subcutaneous emphysema in the neck bilat...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2016.01.033
更新日期:2016-06-01 00:00:00
abstract::Certain laryngeal procedures require a sedated patient who is responsive to allow for the assessment of vocalization. Dexmedetomidine as a single agent for sedation and anxiolysis for awake laryngoplasty in a patient with unilateral vocal fold paralysis is presented. ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2008.11.009
更新日期:2009-09-01 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::Hyperkalemia was found in an immunocompromised patient undergoing emergency cystoscopy. The cause of the hyperkalemia was an intraperitoneal rupture of the bladder. This case report discusses conditions that predispose patients to bladder rupture and anesthetic management of hyperkalemia. ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(91)90095-5
更新日期:1991-11-01 00:00:00
abstract::We report a 31-year-old woman scheduled for a right frontal craniotomy and debulking of a recurrent grade 3 astrocytoma. Mannitol was given at the request of the surgeons. Peaked T waves were noted on electrocardiography, and electrolyte analysis showed hyperkalemia and hyponatremia. ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2006.09.005
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:Childhood and adolescent obesity increased in recent decades, and caregivers face an increasing number of obese pediatric surgical patients. Some clinical and pharmacogenetic data suggest that obese patients have altered pain sensitivity and analgesic requirements. OBJECTIVE:To test the primary hypothesis t...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2020.109729
更新日期:2020-06-01 00:00:00
abstract::A 27-year-old parturient developed a severe headache after placement of a labor epidural catheter. A presumptive diagnosis of an occult postdural puncture headache (PDPH) was made, and the patient was treated with an intravenous (IV) infusion of 500 mg of caffeine sodium benzoate (CSB) to vasoconstrict dilated cerebra...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(92)90121-g
更新日期:1992-01-01 00:00:00
abstract:STUDY OBJECTIVE:To assess the clinical impact of paravertebral blocks (PVBs) on the immediate outcome of patients undergoing radical prostatectomy. DESIGN:Retrospective review. SETTING:Urology ward of a university medical center. MEASUREMENTS:Records of 100 consecutive patients who underwent a radical prostatectomy ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2006.12.003
更新日期:2007-06-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the effects of epinephrine (1:200,000) in the epidural space on the incidence of blood vessel injury by epidural catheter insertion for cesarean section. DESIGN:Prospective observational study. SETTING:University-affiliated teaching hospital. PATIENTS:Four hundred laboring women with sing...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2014.09.004
更新日期:2015-02-01 00:00:00
abstract:STUDY OBJECTIVE:To determine if practicing anesthesiologists recommend preoperative evaluations consistent with the 2007 ACC/AHA guidelines on perioperative care. DESIGN:Survey instrument. SETTING:Academic medical center. SUBJECTS:ASA membership. MEASUREMENTS:In this Web-based survey, participants were presented wi...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2011.11.007
更新日期:2012-09-01 00:00:00
abstract::Patients with severely impaired left ventricular function, an uncorrectable coronary artery disease, and a recent myocardial infarction are at high risk of cardiac complications after major noncardiac surgery. We present two patients with extensive three-vessel coronary artery disease who underwent intraperitoneal sur...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(99)00048-3
更新日期:1999-06-01 00:00:00
abstract::We report an interaction of a transesophageal atrial pacemaker (TAP) with a permanently implanted pacemaker in a cardiac patient who had undergone ablative therapy for atrial tachyarrhythmia 5 years earlier. The patient's permanent A-V pacemaker was completely inhibited by the TAP, and there was loss of ventricular co...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(99)00107-5
更新日期:1999-12-01 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:The aim of this 12-year case series was to review the drugs used during anesthetic management of patients with diagnosis of or risk criteria for Brugada syndrome (BrS), and to document any possible association between these drugs and arrhythmogenic activity or unexplained hemodynamic instability. DESIG...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2016.09.031
更新日期:2017-02-01 00:00:00
abstract::We report a series of successful awake fiberoptic intubations in patients with critical (unstable, difficult) airways using the alpha(2)-agonist, dexmedetomidine. Dexmedetomidine has several desirable pharmacologic properties, including sedation, anxiolysis, hypnosis, analgesia, amnesia, antisialagogue effects, and a ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2006.09.006
更新日期:2007-08-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the efficacy of thoracic epidural analgesia (TEA) in scoliosis surgery. DESIGN:Descriptive clinical study. SETTING:University hospital. PATIENTS:15 ASA physical status I, II, and III patients undergoing thoracolumbar scoliosis correction. INTERVENTIONS:TEA was performed at three to 5 cm ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2009.10.011
更新日期:2010-09-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate whether children with Down Syndrome are at increased risk of bradycardia and hypotension during and following sevoflurane induction. DESIGN:Retrospective study. SETTING:University-affiliated children's hospital. MEASUREMENTS:The records of children with Down syndrome and a sample matched ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2010.05.002
更新日期:2010-12-01 00:00:00
abstract::Vagus nerve stimulation (VNS) for medically refractory seizures has been an approved therapy by the Food and Drug Administration since 1997, with additional approval as an adjunct therapy for major depression granted in 2005. Potential applications for VNS therapy in obesity, neuropsychiatric disorders, and chronic pa...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,评审
doi:10.1016/j.jclinane.2009.10.002
更新日期:2010-05-01 00:00:00
abstract::Designing a successful block rotation for anesthesiology residents requires not only an appropriate curriculum but also a set of teaching tools, which promote learning. Traditional clinical rotations in Anesthesiology residencies emphasize clinical teaching, supported by interaction with staff. Since Perioperative Med...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(00)00136-7
更新日期:2000-05-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the opioid-sparing and analgesic effect of diclofenac sodium in ambulatory nonimmersion extracorporeal shock wave lithotripsy (ESWL). DESIGN:Randomized, double-blind, placebo-controlled study. SETTING:Large referral hospital. PATIENTS:Twenty-seven ASA physical status I and II patients wit...
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(93)90142-2
更新日期:1993-03-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the safety and efficacy of single inferior injection peribulbar block administered by anesthesiologists prior to cataract surgery. DESIGN:Retrospective chart review. SETTING:Freestanding surgery center (teaching). PATIENTS:1,074 consecutive patients who were treated over a two-year period...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章
doi:10.1016/s0952-8180(97)00005-6
更新日期:1997-06-01 00:00:00
abstract::Valvular heart disease in a parturient presenting for Cesarean section is challenging. A 25 year old primigravida parturient with severe mitral stenosis, mild mitral regurgitation, mild aortic regurgitation, and mild pulmonary arterial hypertension required Cesarean delivery after developing pulmonary edema. Low-dose ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2013.12.009
更新日期:2014-05-01 00:00:00
abstract:STUDY OBJECTIVE:To compare a multiport, firm-tipped, close-ended, epidural catheter (Portex catheter) with a uniport, open-ended, soft-tipped, wire-reinforced catheter (Arrow catheter) in obstetric patients. STUDY DESIGN:Prospective data collection for intradepartmental quality assurance. SETTING:Obstetric unit in a ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(00)00116-1
更新日期:2000-03-01 00:00:00
abstract:STUDY OBJECTIVE:Preoperative anxiety is commonly reported by people undergoing surgery. A significant number of studies have found a correlation between preoperative anxiety and post-operative morbidity. Various methods of complementary and alternative medicine (CAM) were found to be effective in alleviating preoperati...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2015.10.017
更新日期:2016-03-01 00:00:00
abstract:STUDY OBJECTIVE:To investigate whether the type of anesthetic agent administered affects the antitussive effect of remifentanil. DESIGN:Prospective randomized study. SETTING:Operating room of a university hospital. PATIENTS:78 ASA physical status 1 and 2 women, aged 20 to 65 years, who were scheduled to undergo a th...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2014.02.002
更新日期:2014-09-01 00:00:00
abstract::A 14 month old, 19 kg female infant with aminotic band syndrome and severe craniofacial malformations presented for placement of an open gastrostomy tube. Spontaneous ventilation was maintained while an "awake look" was performed with the video laryngoscope using intravenous propofol (30 mg total) for sedation. A Grad...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2011.07.004
更新日期:2012-03-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the safety and efficacy of monitored anesthesia care (MAC) in patients who undergo a novel treatment for hepatocellular cancer in which procedure-related hemodynamic instability is problematic. DESIGN:Nonrandomized open study. SETTING:University cancer center operating room. PATIENTS:Nine...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章
doi:10.1016/s0952-8180(97)00031-7
更新日期:1997-05-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the optimal time in which to make intraocular pressure (IOP) measurements in children following tracheal intubation. DESIGN:Randomized, controlled trial. SETTING:Operating rooms of a tertiary-care children's hospital. PATIENTS:Thirteen healthy children undergoing elective strabismus corr...
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(91)90226-d
更新日期:1991-07-01 00:00:00