Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Phenylephrine in the prevention of hypotension following spinal anesthesia for cesarean delivery.
Phenylephrine and ephedrine were compared in the prevention of maternal hypotension following spinal anesthesia for elective cesarean delivery. ⋯ Phenylephrine is as effective as ephedrine in the treatment of maternal hypotension, and when used in small incremental bolus injections, it appears to have no adverse neonatal effects in healthy, nonlaboring parturients.
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Randomized Controlled Trial Clinical Trial
Does 360 ml of apple juice ingested before elective surgery worsen gastric volume and acidity in patients given acid aspiration prophylaxis?
To evaluate whether 360 ml of oral clear liquids consumed within 4 hours of elective surgery worsens gastric volume and acidity in patients given acid aspiration prophylaxis. ⋯ Three hundred and sixty ml of apple juice consumed within 4 hours of elective surgery by patients given ranitidine and metoclopramide did not worsen gastric volume and acidity.
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Case Reports
Pulmonary edema and coagulopathy following intrauterine instillation of 32% dextran-70 (Hyskon).
Hysteroscopy using 32% Dextran-70 in 10% dextrose (Hyskon) is a common outpatient procedure. We report a case of pulmonary edema and coagulopathy in a 38-year-old, 48 kg female who had hysteroscopy and removal of an endocervical polyp using 700 ml of Hyskon over a 2-hour period. Low percutaneous oxygen saturation (SpO2) and vaginal bleeding developed postoperatively. ⋯ The patient developed overt pulmonary edema following the hysterectomy and was treated with positive pressure ventilation. The pathophysiology for the development of pulmonary edema and coagulopathy is discussed. Recommended limits for Hyskon volumes and instillation times are emphasized, as is careful recording of these parameters.
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To determine retrospectively the effect of high-dose opiate-oxygen (O2) anesthetic technique on intraoperative ventricular fibrillation in high-risk neonates. ⋯ High-dose opiate-O2 anesthesia in these patients markedly decreased intraoperative ventricular fibrillation. Other clinical reports and recent experimental work suggest that this finding is due to high-dose opiates rather than the avoidance of N2O.
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To obtain evidence for intraoperative registration of auditory information in patients undergoing elective surgery. ⋯ The anesthetized patients did not exhibit indirect memory for music played intraoperatively, at least to the extent required to demonstrate an exposure effect.