Abstract:
STUDY OBJECTIVE:To document the effects of compromised respiratory function on oxygen saturation (SpO2) after cesarean section via the telemetric pulse oximetry network (TPON) for 24 continuous hours. DESIGN:Prospective study. SETTING:Postpartum ward of a university hospital. PATIENTS:ASA physical status I or II parturients undergoing cesarean section. INTERVENTIONS:Healthy parturients were assigned to 1 of 3 anesthetic-postoperative morphine regimens as follows: general anesthesia-parenteral morphine as needed (GA/PM; n = 11); epidural anesthesia-parenteral morphine as needed (EA/PM; n = 15); epidural anesthesia-epidural morphine 4 to 5 mg (EA/EM; n = 10). MEASUREMENTS AND MAIN RESULTS:For 24 continuous hours after cesarean section, SpO2, heart rate, and plethysmogram every 10 seconds were recorded by the TPON computer. In addition, pain, somnolence, respiratory rate (RR), and side effects were recorded every 30 minutes to 2 hours. SpO2 less than 94% and less than 92% occurred least with GA/PM. The highest mean cumulative time of SpO2 between 95% and 90% occurred with EA/EM. The longest episode of SpO2 less than 92% and the lowest SpO2 for more than 1 minute also occurred with EA/EM. With all 3 regimens, SpO2 decreased to less than 80% for 20 to 30 seconds at a time, but the lowest SpO2 (less than 85%) for more than 1 minute occurred with EA/EM in 1 patient and was associated with somnolence that required treatment. With all 3 regimens, average RR was within normal limits, but mean RR was significantly lower with EA/EM than with GA/PM or EA/PM from the 8th to the 14th postoperative hours. Somnolence did not differ significantly among the 3 regimens. Pain score was significantly lower with EA/EM than with GA/PM or EA/PM for the first 20 hours. CONCLUSIONS:All 3 regimens risked low SpO2, with the EA/EM regimen having the highest risk but the best analgesia. Neither general nor epidural anesthesia combined with postoperative parenteral morphine influenced SpO2 postoperatively. In this study, the TPON provided a feasible method of detecting hypoxemia early on in the general ward setting.
journal_name
J Clin Anesthjournal_title
Journal of clinical anesthesiaauthors
Pan PH,James CFdoi
10.1016/0952-8180(94)90009-4subject
Has Abstractpub_date
1994-03-01 00:00:00pages
124-8issue
2eissn
0952-8180issn
1873-4529pii
0952-8180(94)90009-4journal_volume
6pub_type
临床试验,杂志文章,随机对照试验abstract:STUDY OBJECTIVE:Neuraxial blockade may increase external cephalic version (ECV) success rates. This survey aimed to assess the frequency and characteristics of neuraxial blockade used to facilitate ECV. SETTING AND DESIGN:We surveyed Society for Obstetric Anesthesia and Perinatology members regarding ECV practice usin...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2016.05.040
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Postoperative residual neuromuscular blockade (RNMB) is a common complication in the postanesthesia care unit (PACU), but also one of the most controversial issues. Many studies and trials demonstrated that some methods and techniques can reduce the incidence and the extent of the phenomenon. STUDY OBJECTIV...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2016.07.031
更新日期:2016-12-01 00:00:00
abstract::Recent pharmacologic evidence supports the importance of the integrity of the endothelium in modulating vascular reactivity. The endothelial cells produce one or more endothelium derived relaxing factor(s) or EDRF that cause relaxation of vascular smooth muscle cells through production of cyclic guanosine monophosphat...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,评审
doi:10.1016/0952-8180(88)90033-5
更新日期:1988-01-01 00:00:00
abstract:STUDY OBJECTIVE:Selecting candidates for residency positions is challenging and there is little research on the correlation between commonly used selection criteria and subsequent performance in anesthesiology. This study examined the association between the selection measures and post-recruitment performance in reside...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2017.03.052
更新日期:2017-06-01 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::Alzheimer's disease is a form of dementia that is estimated to affect approximately 3 to 4 million Americans. Given the substantial number of people affected with this disease, it is likely that anesthesiologists will encounter many patients with Alzheimer's disease. Questions as to potential problems including inform...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,评审
doi:10.1016/s0952-8180(02)00483-x
更新日期:2003-02-01 00:00:00
abstract:STUDY OBJECTIVE:To determine if acquired long QT syndrome following right or left, radical or modified, neck dissections result in malignant arrhythmias or deaths. DESIGN:Prospective study. SETTING:Inpatient head and neck service of the Massachusetts Eye and Ear Infirmary. PATIENTS:69 patients who underwent extensiv...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(94)00015-v
更新日期:1995-02-01 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: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:STUDY OBJECTIVE:To test the hypothesis that midazolam potentiates thiopental sodium-induced unconsciousness. DESIGN:Randomized, double-blind study. SETTING:A university medical center. PATIENTS:Fifty nonpremedicated ASA physical status I and II adult patients scheduled for eye surgery. INTERVENTIONS:Intravenous (IV...
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)90177-o
更新日期:1991-09-01 00:00:00
abstract:OBJECTIVE:To evaluate changes in cardiac troponin-I levels after major vascular surgery and their association with early and late postoperative cardiac complications. DESIGN:Prospective, observational investigation. SETTING:University teaching hospital. PATIENTS:75 consecutive patients undergoing major vascular surg...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章
doi:10.1016/j.jclinane.2005.11.005
更新日期:2006-06-01 00:00:00
abstract::This case describes a postoperative complication after single-lung ventilation in a 10-year-old patient scheduled for scoliosis repair. This patient underwent an anterior thoracoscopic excision of several vertebral discs followed by a posterior double-rod fixation of her spine. The postoperative course was complicated...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(02)00482-8
更新日期:2003-03-01 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::We anesthesized a patient susceptible to malignant hyperthermia (MH) three different times by epidural anesthesia with different types of local anesthetics. His skinned fiber test showed a marked acceleration of calcium (Ca2+)-induced Ca2+ release (CICR). When ester type local anesthetic was used for ankle contracture...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(95)00204-9
更新日期:1996-03-01 00:00:00
abstract:STUDY OBJECTIVE:To compare the hemodynamic effects of two different concentrations of pentastarch hydroxyethyl starch (HES; 200/0.5) solutions with a 4% human albumin solution for fluid resuscitation. DESIGN:Open-label, randomized, controlled study. SETTING:Medical-surgical intensive care unit. PATIENTS:34 consecuti...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2008.05.022
更新日期:2008-11-01 00:00:00
abstract::Placement of a central venous catheter into an internal thoracic vein occurs in approximately 2% of all catheterizations. A case in which a pulmonary artery catheter was trapped within the internal thoracic vein during orthotopic heart transplantation is presented. ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2010.03.010
更新日期:2011-05-01 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: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::Carditis can complicate Lyme disease in an estimated <5% of cases, and cardiogenic shock and severe cardiac arrhythmias are described with electrocardiographic abnormalities that could be suggestive of coronary manifestations. We report a case of severe persistent biventricular heart failure complicated by cardiac arr...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2016.08.005
更新日期:2016-12-01 00:00:00
abstract:STUDY OBJECTIVE:The aim of this study is to compare the effects of intravenous single-dose dexketoprofen trometamol and diclofenac sodium 30 minutes before the end of the surgery on relief of postoperative pain in patients undergoing laparoscopic cholecystectomy. DESIGN:A randomized fashion. SETTING AND PATIENTS:Sixt...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2016.02.020
更新日期:2016-08-01 00:00:00
abstract::A case of fulminant hepatic failure two days following an uneventful operation during isoflurane anesthesia is presented. Investigations included elevated bilirubin and serum transaminases in the absence of any other cause of hepatic dysfunction. The patient died on the fourth postoperative day. Subsequent postmortem ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2011.12.004
更新日期:2012-09-01 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::Over a 12-month period, 1,743 patients were retrospectively evaluated for anaphylactic/anaphylactoid reactions during cardiac surgery. Reactions to protamine, vancomycin, blood, and metocurine were observed in eight patients (0.46%). Baseline to reaction mean arterial pressures decreased from 81 +/- 9 mmHg to 50 +/- 7...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(89)90005-6
更新日期:1989-01-01 00:00:00
abstract::The benefits of cardiopulmonary exercise testing have been well established. Certain patient groups present challenges for conducting such a test. We were presented with a patient with a permanent tracheostomy at the preoperative assessment clinic. We describe our technique in overcoming the problem of connecting him ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2016.04.019
更新日期:2016-11-01 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::We describe a case of orthotopic liver transplantation used as a therapeutic method to correct high output cardiac failure related to a liver arteriovenous fistula due to hereditary hemorrhagic telangiectasia. Detailed hemodynamic changes as they occurred during liver transplantation are described. ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(00)00160-4
更新日期:2000-06-01 00:00:00
abstract:PURPOSE:The aim of this study was to evaluate the effect of neuraxial blocks on surgical blood losses and on the number of patients requiring blood transfusion. METHODS:A search of the American National Library of Medicine's PubMed up to November 12, 2004, was performed. Twenty-four studies could be kept for analysis....
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,meta分析
doi:10.1016/j.jclinane.2005.08.013
更新日期:2006-03-01 00:00:00
abstract::Administration of vecuronium by infusion is an increasingly common technique, both in the operating room and in the intensive care unit (ICU), for patients requiring prolonged neuromuscular blockade and mechanical ventilation. The major advantage of vecuronium over older neuromuscular blocking agents is its rapid excr...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(90)90107-e
更新日期:1990-07-01 00:00:00
abstract:STUDY OBJECTIVE:To determine whether the previously published relationship between anesthetic technique and rate of surgical site infections (SSIs) was influenced by institution specific effects. DESIGN:Retrospective Review of Quality Assurance and Hospital Epidemiology databases. SETTING:Metropolitan medical center....
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2014.04.015
更新日期:2014-12-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate whether isopropyl alcohol vapor is an effective treatment for postoperative nausea and vomiting. DESIGN:Double-blind, randomized, controlled study. SETTING:Pediatric surgery center. PATIENTS:91 ASA physical status I and II children age 6-16 years, scheduled to undergo general anesthesia 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(99)00035-5
更新日期:1999-05-01 00:00:00