Journal of clinical anesthesia
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Case Reports
Massive retrograde acute type B aortic dissection in a postpartum woman with a family history of Marfan syndrome.
Acute aortic dissection is rare but potentially catastrophic complication of pregnancy. Aortic root enlargement, congenital bicuspid aortic valve disease, and Marfan syndrome have been identified as critical risk factors for peripartum aortic dissection. Most of the aortic dissections reported to date involve the ascending aorta and occur before delivery, but only a few cases of postpartum aortic dissection have been described. In this report, we discuss the management of a multigravid parturient with an extensive family history of Marfan syndrome who developed a massive retrograde type B aortic dissection 7 days after a normal spontaneous vaginal delivery.
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Randomized Controlled Trial Comparative Study
Effect of preoperative oral erythromycin, erythromycin-ranitidine, and ranitidine-metoclopramide on gastric fluid pH and volume.
To determine whether combining erythromycin with ranitidine is more efficacious than erythromycin or established ranitidine-metoclopramide combination in reducing the volume and acidity of gastric aspirate. ⋯ Erythromycin and ranitidine combination is more efficacious than erythromycin alone in reducing the acidity and volume of gastric fluid. No difference was found between erythromycin-ranitidine and ranitidine-metoclopramide combination.
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Randomized Controlled Trial
Blocking noise but not music lowers bispectral index scores during sedation in noisy operating rooms.
To determine whether playing music or blocking noise can reduce bispectral index (BIS) values during propofol sedation. ⋯ Blocking noise is more effective than playing music in reducing BIS scores during propofol sedation in a noisy environment.
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Thoracic bilateral paravertebral block is a technique commonly used in the ambulatory setting for numerous plastic surgery procedures. Paravertebral block has not been reported with abdominoplasty surgery. This case series explores this anesthetic technique in the inpatient and day patient setting.
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We investigate an incident in which a carbon dioxide absorber caused difficulty with ventilation. The problem as it developed throughout the anesthetic, and clues that led to the determination that the carbon dioxide canister was the problem, is discussed.