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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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.
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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.
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To determine the changes in anxiety level and need for information at three different time points before surgery. ⋯ The frequency of anxious patients is variable at different time points before surgery. The factors correlating with anxiety before surgery are nonmodifiable. Providing information to those individuals is the only modifiable option.