Journal of clinical anesthesia
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To investigate whether patients with postural orthostatic tachycardia syndrome (POTS) developed unexpected perioperative complications. ⋯ Intraoperative hypotension, but not tachycardia, was observed in three of 13 patients with POTS who received general anesthesia for a variety of surgical procedures using multiple medications and techniques.
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Sheehan's syndrome is a well described entity that refers to hypopituitarism with pituitary infarction secondary to postpartum shock or hemorrhage. Antepartum pituitary infarction is a very rare condition that has been reported only in patients with longstanding type 1 diabetes mellitus or uncontrolled gestational diabetes. A case of severe, acute hypopituitarism in the setting of hemorrhagic shock from a gunshot wound is presented. Our case report highlights the importance of including hypopituitarism in the differential diagnosis of a critically ill parturient.
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To determine the most suitable effect-site concentration of remifentanil during lightwand intubation when administered with a target-controlled infusion (TCI) of propofol at 4.0 μg/mL without neuromuscular blockade. ⋯ A remifentanil effect-site concentration of 2.16 ± 0.19 ng/mL given before a propofol effect-site concentration of 4 μg/mL allowed lightwand intubation without muscle relaxant.
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Letter Case Reports
Anesthetic management of a patient who swallowed a knife.
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von Willebrand disease (VWD) is the most common hereditary bleeding disorder in humans, with an estimated prevalence of 0.5% to 1%. Patients with VWD are at increased risk of perioperative bleeding complications. This review provides an evidence-based overview of VWD and its management during the perioperative period.