Journal of clinical anesthesia
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Anesthesia-related complications are the sixth leading cause of pregnancy-related maternal mortality in the United States. Difficult or failed intubation following induction of general anesthesia for cesarean delivery remains the major contributory factor to anesthesia-related maternal complications. Although the use of general anesthesia has been declining in obstetric patients, it may still be required in selected cases. Because difficult intubation in obstetric anesthesia practice is frequently unexpected, careful and timely preanesthetic evaluation of all parturients should identify the majority of patients with difficult airway and avoid unexpected difficult airway management.
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To determine the applicability and reliability of a screening questionnaire to detect patients at high-risk of latex allergy; to assess the importance of other allergies such as profilin allergies (pollinosis) for presence of latex sensitization; and to determine the clinical effectiveness of preemptive avoidance of latex exposure in high-risk patients. ⋯ The questionnaire allowed the identification of most patients at high risk for latex allergy. In isolated pollinosis no changes in any specific IgE levels were detectable. Strict avoidance of perioperative latex exposure in high-risk patients increases safety during anesthesia and surgery.
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To evaluate whether our criteria for immediate postoperative extubation predicts successful extubation in living-related liver transplantation of the right lobe, and to test the effects of our standardized anesthetic technique on the success of immediate postoperative extubation. ⋯ Immediate extubation of selected living-related liver transplant recipients can be a safe procedure. Anesthetic management to immediate extubation seems appropriate and the derived guidelines appear acceptable.
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We present an unusual case in which a pediatric patient sustained iatrogenic pulmonary contusion resulting in severe hemoptysis. Aside from being a rare complication of pediatric extracorporeal shock wave lithotripsy, our case is unique in regard to the timing and apparent severity of hemoptysis.
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A rare case of postoperative cardiac arrest in an otherwise healthy, 49-year-old female patient who had a laparoscopic hysterectomy, is presented. The cause of cardiac arrest was due to massive pulmonary embolism, which was detected by transesophageal echocardiography. Laparoscopic surgery is regarded as a less invasive procedure and provides a lower risk for postoperative complications. However, our is a case reminer that pneumoperitoneum may interfere with venous flow of lower extremities and predispose one to deep vein thrombosis or pulmonary embolism.