Journal of clinical anesthesia
-
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.
-
Randomized Controlled Trial
Supplementation of retrobulbar block with clonidine in vitreoretinal surgery: effect on postoperative pain.
To evaluate the effect of clonidine when added to local anesthetics on duration of postoperative analgesia during retrobulbar block. ⋯ The addition of clonidine 0.5 μg/kg to the local anesthetics of a retrobulbar block for vitreoretinal surgery decreases the frequency of postoperative pain and prolongs the time of analgesia.
-
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.
-
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.
-
Case Reports
Supraglottic jet ventilation assists intubation in a Marfan's syndrome patient with a difficult airway.
A 37 year old woman with Marfan's syndrome underwent an elective gynecologic procedure. Mask ventilation was not difficult but initial direct laryngoscopy showed no view of the glottic opening. ⋯ The technique provided oxygenation and ventilation during intubation and assisted intubation of a patient with a grade III glottic view. No hypoxia or barotrauma were noted during the intubation.