Journal of clinical anesthesia
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To investigate whether preinduction glucose is an important predictor for perioperative insulin management in patients undergoing cardiac surgery. ⋯ In cardiac surgical patients with a preinduction glucose above 110 mg/dL, even if diabetes was not previously suspected, perioperative insulin requirements were higher, and intraoperative insulin management is more difficult than in those with a preinduction glucose 110 mg/dL or lower. Preinduction glycemia and BMI are good predictors of perioperative insulin management. Preinduction glycemia above 110 mg/dL predicts difficult perioperative glucose control and, moreover, that a preinduction blood glucose of 110 mg/dL or lower is associated with less insulin need.
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Randomized Controlled Trial Comparative Study
A comparison of spinal anesthesia with small-dose lidocaine and general anesthesia with fentanyl and propofol for ambulatory prostate biopsy procedures in elderly patients.
To compare operating conditions, intraoperative adverse events, recovery profiles, postoperative adverse effects, patient satisfaction, and costs of small-dose lidocaine spinal anesthesia with those of general anesthesia using fentanyl and propofol for elderly outpatient prostate biopsy. ⋯ Spinal anesthesia with 10 mg of hyperbaric 1% lidocaine may be a more suitable alternative to general anesthesia with fentanyl and propofol for ambulatory elderly prostate biopsy in terms of safety and costs.
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We present the case of a young patient who underwent a prolonged urological procedure in the lateral decubitus position. The patient's postoperative course was complicated by rhabdomyolysis manifested by elevated levels of serum creatine phosphokinase and the presence of myoglobin in urine and blood. ⋯ Subsequently, the patient had an uneventful recovery. The linkage between surgical positioning, prolonged surgery time, and rhabdomyolysis is discussed.