Journal of clinical anesthesia
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Case Reports Clinical Trial
Respiratory depression: an adverse outcome during patient controlled analgesia therapy.
Patient-controlled analgesia (PCA) is one of the more popular means of controlling postoperative pain. However, there is very little in the literature concerning the adverse outcome of respiratory depression in PCA. ⋯ The respiratory depressions were associated with drug interactions, continuous narcotic infusion, nurse- or physician-controlled analgesia and inappropriate use of PCA by patients. This report identified the common precipitating factors in PCA-associated respiratory depression and its prevention.
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Clinical Trial Controlled Clinical Trial
Hemodynamic effects of intrathecal fentanyl in nonlaboring term parturients.
To determine the effect of intrathecal fentanyl on maternal hemodynamics. ⋯ Intrathecal administration of fentanyl 25 micrograms in nonlaboring term parturients does not produce clinically important maternal hemodynamic changes.
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We present 12 case reports from patients treated with more than 600 mg of morphine per day. We found no "opioid-nonresponsive pain" under treatment with a combination of morphine and nonopioids, supplemented with coanalgesics where appropriate. ⋯ Serious adverse effects were not observed. Episodes of break-through pain, dysphagia, and dyspnea caused by far advanced cancer disease were seen frequently.
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Comparative Study Clinical Trial
Bowel function recovery after radical hysterectomies: thoracic epidural bupivacaine-morphine versus intravenous patient-controlled analgesia with morphine: a pilot study.
To determine if the use of continuous epidural bupivacaine-morphine in the perioperative period is associated with a significant decrease in the recovery time of postoperative ileus when compared with parenteral morphine administration. ⋯ The use of thoracic epidural bupivacaine-morphine results in a decrease in the duration of postoperative ileus, which was associated with earlier hospital discharge.
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Comparative Study Clinical Trial
Quantitative improvement in laryngoscopic view by optimal external laryngeal manipulation.
To determine the improvement in laryngoscopic view obtained using both the Macintosh and Miller blades by applying optimal external laryngeal manipulation (OELM). ⋯ We conclude that OELM can improve the laryngoscopic view by at least one whole grade, that the best way to determine OELM for an individual patient is on an empirical basis by manipulation of the larynx with the laryngoscopist's right hand, and that OELM should be an instinctive and reflex response to any "A" of 2, 3, or 4.