Journal of clinical anesthesia
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Placement of double-lumen endobronchial tubes (DLTs) into the trachea can be difficult because of their size and configuration. For patients with abnormal airway anatomy and anticipated difficult tracheal intubation, DLT placement can be extremely challenging. We present our experience using lighted stylets to facilitate insertion of DLTs in a series of patients with difficult airway anatomy.
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This case report describes the use of a bronchial blocker (BB) with a wheel-controlled tip (Cohen flexitip endobronchial blocker) to provide initially middle and lower right lobe isolation and then right lung isolation (RLI) during right lower lobectomy in a patient with compromised pulmonary function preoperatively. As predicted, RLI and one-lung ventilation were associated with worsening oxygenation. ⋯ The BB design made lobar isolation easier and enabled repositioning of the BB during surgery. The techniques used for BB insertion as well as lobar and lung separation are described.
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Randomized Controlled Trial Comparative Study
The effect of injection of two vs 10 mL saline on the subsequent spread and quality of epidural analgesia in parturients.
To determine whether two vs 10 mL of saline injected into the epidural space affects the subsequent spread and quality of epidural analgesia in parturients. ⋯ 10 mL saline was associated with a higher total number of dermatomes blocked for both cold and pinprick sensation than the two mL saline. However, the pain relief was adequate in both groups, and two mL saline was as effective as the 10 mL in the ease of catheter insertion and prevention of intravascular cannulation.
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Randomized Controlled Trial
Does clonidine 50 microg improve cervical plexus block obtained with ropivacaine 150 mg for carotid endarterectomy? A randomized, double-blinded study.
To evaluate the effects of adding 50 microg clonidine to 150 mg ropivacaine for superficial cervical plexus block in patients undergoing elective carotid endarterectomy (TEA). ⋯ Adding 50 microg clonidine to 150 mg ropivacaine for superficial cervical plexus block shortened the onset time and improved the quality of surgical anesthesia in patients undergoing elective TEA.
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Smoking is the single most cause of preventable disease and premature death in the United States. We discuss potential hazards that the anesthesiologist should be aware of when caring for patients who abuse tobacco. A review of recent preoperative smoking cessation initiatives is also provided in addition to recommendations on how anesthesiologists may use the preoperative visit as an opportunity to play a more active role in reducing the burden of tobacco-related disease.