Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study
The efficacy of intravenous paracetamol versus tramadol for postoperative analgesia after adenotonsillectomy in children.
To evaluate the efficacy and the quality of recovery with intravenous (IV) paracetamol versus tramadol for postoperative analgesia after adenotonsillectomy in children. ⋯ The IV formulation of paracetamol was associated with similar analgesic properties and early recovery to that of IV tramadol after adenotonsillectomy in children.
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To determine whether parturients can reliably identify their midline during epidural or spinal needle insertion, and to determine whether parturient feedback helps the anesthesiologist successfully identify the midline. ⋯ Most patients, including morbidly obese patients, are helpful in identifying the midline during neuraxial anesthesia.
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To apply ergonomic task analysis to the performance of ultrasound-guided (US-guided) femoral nerve block (FNB) in an acute hospital setting. ⋯ Performance of US-guided FNB presents ergonomic challenges and was suboptimal during most of the procedures observed. Formal training in US-guided peripheral nerve blockade should include reference to ergonomic factors.
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The case of a 78 year-old woman who underwent a right lower lobectomy using a 35-French, left-sided, double-lumen endobronchial tube (DLET) is presented. Multiple adjustments were needed for the DLET's proper placement. At the end of surgery, sudden loss of tidal volume with a large air leak from the patient's mouth was noted. ⋯ In the intensive care unit, the massive air leak from the mouth recurred during mechanical ventilation. Nasal fiberoptic bronchoscopic examination showed a longitudinal laceration of the membranous portion of the trachea extending from the subglottic area to the orifice of the right bronchus. Surgical repair of the tear was performed.
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Editorial Comment
Finding the ever elusive vertebral midline: does Mother know best?