Journal of clinical anesthesia
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Review Case Reports
Care of the injured Jehovah's Witness patient: case report and review of the literature.
Care for the Jehovah's Witness patient can be a challenge and often a dilemma to clinicians because of the patient's religious beliefs and teachings against receiving blood and blood products, especially in emergency or trauma settings. We present a case of a severely injured elderly Jehovah's Witness patient who survived. We also review the literature and offer an organized approach to care for such patients.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Nasal versus oral fiberoptic intubation via a cuffed oropharyngeal airway (COPA) during spontaneous ventilation.
To compare the success rate of nasal versus oral fiberoptic intubation in anesthetized patients breathing spontaneously via the cuffed oropharyngeal airway (COPAtrade mark). ⋯ Nasal fiberoptic laryngoscopy is more successful and easy than the oral approach in anesthetized patients who are breathing spontaneously through the COPA.
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Randomized Controlled Trial Comparative Study Clinical Trial
The effects of alfentanil or remifentanil pretreatment on propofol injection pain.
To compare the efficacy of alfentanil, remifentanil, and saline in minimizing the propofol injection pain. ⋯ The remifentanil and alfentanil groups showed significantly less frequency and severity of pain than did the saline group. Remifentanil was effective in preventing propofol injection pain, and should be used at a dose of at least 0.02 mg for this purpose. Remifentanil may be an alternative drug for prevention of propofol injection pain.
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We present a case of postoperative delirium following endoscopic sinus surgery. We postulate a mechanism for this rare event.
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Case Reports
Variable systolic pressure variation and dynamic hyperinflation due to an intrabronchial tumor.
Systolic pressure variation (SPV) is the cyclic change in systolic blood pressure secondary to positive-pressure ventilation. It is normally a good indicator of intravascular volume and often can be substituted for central venous pressure monitoring, but the reliability of SPV for this use depends on the multiple determinants of intrathoracic pressure remaining constant. ⋯ This situation, in turn, caused a marked increase in SPV but, more importantly, it increased variability of the SPV despite normal intravascular volume. We discuss the physiology of SPV and the implications of this case for the use of SPV as a monitor of intravascular volume.