Anesthesia and analgesia
-
Anesthesia and analgesia · Nov 2010
ReviewFocused review: neuraxial morphine and oral herpes reactivation in the obstetric population.
Neuraxial morphine administration is a common strategy for providing postcesarean delivery analgesia. Morphine delivered via this route increases the risk of herpes labialis (oral herpes) reactivation, a disease common in women of childbearing age. A primary concern is risk of transmission to the neonate from maternal reactivation. The benefits to the mother of this form of analgesia outweigh the risk of neonatal herpes acquired postpartum from maternal recurrence because serious neonatal morbidity from recurrent herpes has not been described.
-
Anesthesia and analgesia · Nov 2010
Case ReportsEpidural hematoma after neuraxial blockade: a retrospective report from China.
We conducted a detailed 54-year retrospective review of patients who developed epidural hematoma after neuraxial blockade in a university hospital and throughout Mainland China. Incidence, risk factors, and outcomes in the Chinese population were identified. ⋯ Patients who had a bacterial infection and required emergency surgery were at increased risk of developing epidural hematoma. There is a significant correlation between good neurologic recovery and short interval to decompressive surgery.
-
Anesthesia and analgesia · Nov 2010
A pilot study of respiratory inductance plethysmography as a safe, noninvasive detector of jet ventilation under general anesthesia.
High-frequency jet ventilation is an optimal mode of ventilation for many surgical procedures of the trachea and larynx but has limited monitoring modalities to assess adequacy of oxygenation and/or ventilation. Respiratory inductance plethysmography is a noninvasive monitor of chest and abdominal wall movement with well-established applications in the sleep laboratory. We performed an observational pilot study of respiratory inductance plethysmography as a detector of jet ventilation. ⋯ Respiratory inductance plethysmography was successfully used to detect high-frequency jet ventilation in patients undergoing laryngotracheal surgery. This pilot study demonstrates the feasibility of respiratory inductance plethysmography as a monitor for use during jet ventilation.
-
Anesthesia and analgesia · Nov 2010
Improved accuracy of methemoglobin detection by pulse CO-oximetry during hypoxia.
Methemoglobin in the blood cannot be detected by conventional pulse oximetry and may bias the oximeter's estimate (Spo(2)) of the true arterial functional oxygen saturation (Sao(2)). A recently introduced "pulse CO-oximeter" (Masimo Rainbow SET® Radical-7) that measures SpMet, a noninvasive measurement of the percentage of methemoglobin in arterial blood (%MetHb), was shown to read spuriously high values during hypoxia. In this study we sought to determine whether the manufacturer's modifications have improved the device's ability to detect and accurately measure methemoglobin and deoxyhemoglobin simultaneously. ⋯ The Rainbow's methemoglobin readings are acceptably accurate over an oxygen saturation range of 74%-100% and a methemoglobin range of 0%-14%.
-
Anesthesia and analgesia · Nov 2010
Bradycardia during induction of anesthesia with sevoflurane in children with Down syndrome.
Bradycardia is a complication associated with inhaled induction of anesthesia with halothane in children with Down syndrome. Although bradycardia has been reported after anesthetic induction with sevoflurane in these children, the incidence is unknown. ⋯ Bradycardia during anesthetic induction with sevoflurane was common in children with Down syndrome, with and without a history of congenital heart disease.