Journal of clinical anesthesia
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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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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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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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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.
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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.