Journal of clinical anesthesia
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A 30-year-old parturient requested epidural analgesia during labor. Immediately after the epidural space was presumably identified using the loss-of-resistance-to-air technique, she reported severe back pain, followed by neck pain, which progressed to severe unrelenting headache. An emergency computerized tomographic (CT) scan performed during labor showed air in the intracranial subarachnoid space.
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Patients with Sturge-Weber disease and Klippel Trenaunay syndrome may have several neurologic abnormalities. The effects of hemangiomas in the brain cortex and the spinal cord are responsible for most of the anesthetic challenges associated with this disease, particularly the risks of intracerebral bleeding, disseminated intravascular coagulation (DIC), and airway management. The successful management of this case illustrates that adequate preparation to handle the possible complications may result in safe anesthetic management in patients with these problems.
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Randomized Controlled Trial Comparative Study Clinical Trial
The differential cost of anesthesia and recovery with propofol-nitrous oxide anesthesia versus thiopental sodium-isoflurane-nitrous oxide anesthesia.
To assess the recovery room profile of propofol in outpatient anesthesia and to compare it to the profile of a standard technique. ⋯ The propofol group needed less nursing care and returned to more productive activity earlier than did the thiopental sodium-isoflurane group.
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Randomized Controlled Trial Clinical Trial
The effects of thiopental sodium on fentanyl-induced muscle rigidity in a human model.
To describe a safe human model in which to study the treatment of fentanyl-induced muscle rigidity and report on the efficacy of thiopental sodium for this purpose. ⋯ Thiopental sodium does blunt the degree of muscle rigidity induced by high-dose fentanyl, though not as effectively as does succinylcholine. One can safely isolate an extremity prior to the administration of high-dose fentanyl and a muscle relaxant, intubate the trachea, and ventilate a patient, while retaining the ability to study the effect of centrally acting drugs on fentanyl-induced rigidity in the isolated extremity.