Anesthesia and analgesia
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Anesthesia and analgesia · Sep 2013
The relationship between neuraxial anesthesia and advanced ovarian cancer-related outcomes in the chilean population.
Mixed evidence has been published relating the use of regional anesthesia during oncologic surgery to a decrease in time to cancer recurrence and improvement in overall survival. We investigated whether the use of epidural anesthesia, in addition to general analgesia during and/or after surgical removal of advanced ovarian cancer, has an impact on time to recurrence and overall survival. ⋯ After PS matching and weighting, we found no benefit in overall survival or time to recurrence in patients with advanced stages (International Federation of Gynecologists and Obstetricians IIIC and IV) of ovarian cancer after the use of EA during and after tumor debulking surgery.
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Anesthesia and analgesia · Sep 2013
Stored platelet functionality is not decreased after warming with a fluid warmer.
Warming of IV-administered fluids and blood products is routinely performed in the operating room to help maintain normothermia. Current guidelines recommend against the warming of platelets (PLTs), although there is no evidence for this prohibition in the literature. Our goal in this pilot study was to determine whether the warming of stored PLTs had any effect on their function. ⋯ Although small in size, the results of this study do not support the prohibition against mechanical PLT warming. Studies of PLT activation after warming are also warranted.
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Anesthesia and analgesia · Sep 2013
Case ReportsCase report: quetiapine and refractory hypotension during general anesthesia in the operating room.
Quetiapine is an atypical antipsychotic with known α-adrenergic antagonism. We present a case of refractory hypotension that occurred after induction of general anesthesia in a patient being treated with quetiapine. ⋯ We observed that the hypotension was most responsive to vasopressin. We recommend further investigation regarding the interaction of quetiapine and general anesthesia.
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Anesthesia and analgesia · Sep 2013
Brief report: leaking esophageal probe may lead to false ventilator settings when guiding positive end-expiratory pressure by transpulmonary pressure.
Esophageal pressure (Pes) is a surrogate for intrapleural pressure. Measuring Pes during mechanical ventilation allows for positive end-expiratory pressure adjustments by transpulmonary pressure (PL), which has been shown to improve oxygenation and outcome in acute respiratory distress syndrome patients. In morbidly obese patients, we saw progressively increasing PL measurements, although airway pressure (Paw), intra-abdominal pressure, and patient position did not change. On further examination, we determined that the gradual increases of PL were artifacts caused by a leak in the pressure probes, which resulted in underestimation of Pes and overestimation of PL as derived from the equation Paw - Pes = PL.