Journal of clinical anesthesia
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We describe a case of a failed implanted, programmable, intrathecal infusion pump-and its external programmer-leading to morphine withdrawal symptoms, in a patient with failed back syndrome.
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The acquisition and maintenance of essential psychomotor skills that are only required sporadically is a significant problem in medical training and practice. It is of particular relevance to anesthesiologists with regard to fiberoptic intubation, a technique that may be under-utilized despite its central role in the management of the difficult airway. ⋯ We describe an educational resource (Dexter), which has been developed to overcome these problems. Dexter is a nonanatomical, endoscopic dexterity training system designed to encourage practice and help establish and maintain a state of procedural readiness, even if clinical exposure to difficult airway situations is sporadic.
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In December 2001, the United States Food and Drug Administration (FDA) added a "black box" warning to the labeling for droperidol stating that all doses, even those typically used for postoperative nausea and vomiting, were potentially associated with malignant ventricular dysrhythmias, including torsade de pointes. The 19 cases in which droperidol doses less than 10 mg were allegedly associated with such dysrhythmias are reviewed in detail. Confounding issues present in a majority of the cases make it difficult to incriminate droperidol as the likely cause of the reported adverse events.