Journal of clinical anesthesia
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Clinical Trial
Accelerated recovery from doxacurium-induced neuromuscular blockade in patients receiving chronic anticonvulsant therapy.
To determine whether a drug interaction exists between doxacurium and anticonvulsants. ⋯ Chronic treatment with anticonvulsants results in more rapid recovery from neuromuscular blockade produced by doxacurium.
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Randomized Controlled Trial Comparative Study Clinical Trial
Postoperative pain control with methadone following lower abdominal surgery.
To describe a technique for the use of methadone during and following lower abdominal surgery that integrates its pharmacokinetic and pharmacodynamic properties with the objective of postoperative analgesia; to compare methadone with morphine for postoperative pain control. ⋯ Sustained analgesia with methadone is predicted by its pharmacokinetics. Patients who received 22 +/- 2.9 mg of IV methadone (combined intraoperative and recovery room doses) reported less pain and required minimal additional analgesic over the next 72 hours than did patients who received morphine. This is consistent with sustained therapeutic plasma levels due to methadone's long plasma half-life (54 +/- 20 hours). Use of methadone in this manner is an effective therapy for postoperative pain control and is not associated with toxicity or notable side effects.
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To examine and compare the mechanism of injury, diagnostic findings, initial methods of airway management, and outcome of patients who had upper airway injuries. ⋯ In any patient with possible upper airway injury, plain radiographs of the chest and neck should be obtained to aid in the diagnosis. Elective intubation should be attempted only with a surgical team present and prepared for emergency tracheotomy. Fiber-optic bronchoscopy could be a valuable aid for both intubation and evaluation in such cases.
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Brachial plexus blockade is a commonly used technique for providing surgical anesthesia for the upper extremity. Although various approaches have been described, the axillary approach is the safest and most frequently used. ⋯ A case of false aneurysm of the axillary artery following axillary nerve block is reported. The possible occurrence of this complication should be kept in mind to avoid permanent neurologic sequelae.