Journal of anesthesia
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Journal of anesthesia · Oct 2011
Randomized Controlled Trial Multicenter StudyAdjuvant dexamethasone with bupivacaine prolongs the duration of interscalene block: a prospective randomized trial.
Dexamethasone added to bupivacaine significantly prolongs the duration of interscalene analgesia and motor blockade.
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Journal of anesthesia · Oct 2011
Randomized Controlled TrialEffect of acupuncture on nausea and/or vomiting during and after cesarean section in comparison with ondansetron.
Acupuncture has been used for the management of postoperative nausea and vomiting (PONV). This study compared the effect of electrical acustimulation with ondansetron for preventing intraoperative and postoperative emetic symptoms and improving patient satisfaction. ⋯ Electrical acustimulation is comparable to ondansetron in prevention of PONV during and after cesarean delivery under spinal anesthesia and in improving patient satisfaction.
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Epidural administration of local anesthetics or opioid during general anesthesia is a widespread method for postoperative analgesia. Despite the availability of this technique, inadvertent administration of nonepidural medications into the epidural space can be associated with serious neurological complications. We report a case of accidental epidural rocuronium injection.
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Journal of anesthesia · Oct 2011
Influence of bupivacaine injection dose rate on cardiovascular depression, subsequent hemodynamic course, and related bupivacaine plasma levels in piglets.
Systemic local anesthetic (LA) toxicity resulting from inadvertent intravascular injection of LA is a rare but potentially fatal event. Early recognition of intravascular injection and approaches to improve therapeutic safety are required. This study investigated the influence of intravascular injection dose rate of bupivacaine on bupivacaine plasma levels and timing of LA-induced cardiovascular compromise. ⋯ Higher dose rates of bupivacaine showed much higher plasma bupivacaine levels related to absolute infused dose at MAP 50% and were associated with an increased mortality. Slow administration of LA is recommended to allow timely detection and stopping of inadvertent intravascular administration.
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Journal of anesthesia · Oct 2011
Randomized Controlled TrialThe effect of patient-controlled intravenous analgesia on postoperative hypokalemia in patients undergoing laparoscopic cholecystectomy.
We investigated whether hypokalemia developed during the postoperative period and whether the use of intravenous patient-controlled analgesia (IV-PCA) could decrease the incidence of postoperative hypokalemia in patients who underwent laparoscopic cholecystectomy. ⋯ The results show that hypokalemia developed during the perioperative period and the use of IV-PCA in patients undergoing laparoscopic cholecystectomy effectively decreased the degree and incidence of postoperative hypokalemia on the day of the operation and postoperative day one.