Anesthesia and analgesia
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Anesthesia and analgesia · Jan 2010
Up-down determination of the 90% effective dose of phenylephrine for the treatment of spinal anesthesia-induced hypotension in parturients undergoing cesarean delivery.
Hypotension frequently complicates spinal anesthesia for cesarean delivery, and vasopressors are the mainstay for treatment. The most effective dose of phenylephrine for the treatment of spinal anesthesia-induced hypotension has not been estimated. ⋯ In this study, we estimated that the ED(90) of phenylephrine required to treat spinal anesthesia-induced hypotension in cesarean delivery is approximately 150 microg.
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Anesthesia and analgesia · Jan 2010
Development and validation of predictors of respiratory insufficiency and mortality scores: simple bedside additive scores for prediction of ventilation and in-hospital mortality in acute cervical spine injury.
Numerous studies have developed a "severity score" or "risk index" for mechanical ventilation and mortality, but there are few to predict outcomes for cervical spine injury (CSI) patients. Our objective in this study was to develop a simple bedside additive predictive score for requirement for ventilation and early in-hospital mortality for patients with CSI. ⋯ PRIM scores enable accurate prediction of individual patient risk of need for mechanical ventilation and in-hospital mortality in association with acute CSI.
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Anesthesia and analgesia · Jan 2010
Case ReportsSpinal cord stimulation for severe degenerative joint disease of the shoulder in a patient with severe chronic obstructive pulmonary disease: a new indication?
Approximately 70% of the United States population older than 65 yr has osteoarthritis. Chronic obstructive pulmonary disease (COPD) is also more prevalent in the elderly, and thus, the likelihood of having elderly patients with osteoarthritis and COPD in clinical settings is significant. COPD may preclude the optimum use of opioids, thus the potential to provide pain control with nonpharmacological treatment modalities becomes a valuable option. We present the case of an elderly woman with severe degenerative joint disease of the shoulder and severe COPD in whom spinal cord stimulation was used to provide pain control.
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Anesthesia and analgesia · Jan 2010
Dental sedation by dentists: a view from anesthesiologists working in central Western Brazil.
Anesthesia care has been provided by diverse health professionals worldwide, but little is known about anesthesiologists' views about this. Using a survey, we sought the opinions of a group of Brazilian anesthesiologists regarding nitrous oxide/oxygen and oral minimal/moderate sedation performed by dentists. ⋯ Many anesthesiologists in Central Western Brazil do not sedate dental patients and are not confident that dentists are able to do it. Dental sedation is an issue that still needs to be clarified in this region; the respective roles of physicians and dentists need to be determined to benefit the population.
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Anesthesia and analgesia · Jan 2010
Magnetic resonance imaging findings after uneventful continuous infusion neuraxial analgesia: a prospective study to determine whether epidural infusion produces pathologic magnetic resonance imaging findings.
Magnetic resonance imaging (MRI) is considered the preferred diagnostic tool to determine whether postepidural neurologic symptoms are due to hematoma or abscess. However, there is currently no published information regarding the normal appearance of a MRI after a continuous epidural infusion. In this prospective cohort study, we defined the characteristic appearance of MRI findings after uneventful epidural analgesia. ⋯ The lack of significant collections or mass effects seen in the MRIs of our patients after continuous infusion of epidural analgesia suggests that the presence of these findings in a patient with new neurologic symptoms after administration of epidural analgesia should be considered pathologic and warrant immediate attention.