Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study
Frequency of electrocardiographic changes indicating myocardial ischemia during elective cesarean delivery with regional and general anesthesia: detection based on continuous Holter monitoring and serum markers of ischemia.
To determine the frequency of electrocardiographic (ECG) changes and to assess the occurrence of myocardial ischemia during elective cesarean delivery with either regional or general anesthesia. ⋯ The ST-segment changes are not frequent in healthy women undergoing elective cesarean delivery during either regional or general anesthesia, and we found no evidence of myocardial injury.
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We report two patients with a history of dural puncture who developed paradoxical postural cerebrospinal fluid leak-induced headache. The patients' headache worsened when they were in the recumbent position, and it improved when they were placed upright. ⋯ The patients were successfully treated with autologous epidural blood patch. The mechanism for PPCLH is to be elucidated.
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Case Reports
Inability to ventilate the lungs of a patient with tracheal anomaly and in prone position.
We present the case of an otherwise asymptomatic patient with a rare congenital airway abnormality of the tracheobronchial tree, who developed a complete airway obstruction after being placed in the prone position. The tracheal bronchus, accessory bronchus arising from the trachea superior to its bifurcation at the carina, was identified by fiberoptic bronchoscopic examination. An endotracheal tube can migrate into a tracheal bronchus causing pulmonary atelectasis, hypoxia, or both.
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Intracranial subdural hematoma is a serious complication of spinal anesthesia. We report the case of a 31-year-old woman who presented with headache and neurologic localizing signs after spinal anesthesia for cesarean delivery. She was subsequently diagnosed with a right temporoparietal subdural hematoma. The hematoma was evacuated, and she had good recovery.