Anesthesia and analgesia
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Anesthesia and analgesia · Apr 2009
Repeated episodes of respiratory distress in an obese parturient after cesarean delivery.
A 25-yr-old obese parturient with mild asthma underwent an uneventful spinal anesthetic for primary cesarean delivery. Within 4 h after delivery, the patient twice developed acute shortness of breath, inspiratory stridor, and hypoxemia that required intubation. ⋯ She had a normal echocardiogram and chest computed tomography, but her neck computed tomography showed an enlarged left thyroid lobe asymmetrically compressing the endotracheal tube cuff. We hypothesized that, after delivery, decreased maternal vascular capacitance increased central venous pressure such that venous engorgement of an undiagnosed goiter may have caused symptomatic tracheal compression.
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Anesthesia and analgesia · Apr 2009
The lower limit of cerebral blood flow autoregulation is increased with elevated intracranial pressure.
The cerebral perfusion pressure that denotes the lower limit of cerebral blood flow autoregulation (LLA) is generally considered to be equivalent for reductions in arterial blood pressure (ABP) or increases in intracranial pressure (ICP). However, the effect of decreasing ABP at different levels of ICP has not been well studied. Our objective in the present study was to determine if the LLA during arterial hypotension was invariant with ICP. ⋯ In this atraumatic, elevated ICP model in piglets, the LLA had a positive correlation with ICP, which suggests that compensating for an acute increase in ICP with an equal increase in ABP may not be sufficient to prevent cerebral ischemia.
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Anesthesia and analgesia · Apr 2009
Letter Randomized Controlled Trial Comparative StudyThe EndoFlex tube enhances navigability through the nasal cavity during nasotracheal intubation.