Journal of clinical anesthesia
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To examine the predictive value of social support in postoperative delirium. ⋯ Patients who report low satisfaction with social support may present with a particular vulnerability to postoperative delirium, even after controlling for physical confounding variables and depressive mood.
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Comparative Study
Hemodynamic effects of laparoscopic radiofrequency ablation of liver tumors versus laparoscopic hepatic ultrasound examination.
To compare the hemodynamic changes that occur during laparoscopic radiofrequency ablation of liver metastases with those occurring during laparoscopic ultrasound hepatic examination alone. ⋯ Hemodynamic profiles were similar when comparing laparoscopic radiofrequency ablation of liver metastases with laparoscopic ultrasound hepatic examination alone.
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A common peroneal nerve block at the fibular head is uncommon in clinical practice. The case of a 41 year old, morbidly obese woman requiring right total ankle replacement is presented. Ultrasound-guided common peroneal nerve block was performed at the fibular head after an unsuccessful popliteal approach.
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A 14 month old, 19 kg female infant with aminotic band syndrome and severe craniofacial malformations presented for placement of an open gastrostomy tube. Spontaneous ventilation was maintained while an "awake look" was performed with the video laryngoscope using intravenous propofol (30 mg total) for sedation. A Grade I Cormack-Lehane score was obtained on the monitor. Succinylcholine was then administered intravenously and orotracheal intubation was performed on the first attempt with a size 4.5 endotracheal tube.
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Nerve stimulation may occur despite the presence of a fascial barrier between the needle tip and the nerve, which may prevent appropriate flow or distribution of local anesthetic solution. During an axillary nerve block, ultrasound (US) guidance was used to identify the median nerve. Insertion of a needle with US and nerve stimulator guidance resulted in the appearance of the needle tip in contact with the nerve. ⋯ No injectate was seen below the fascia. With US guidance, the needle was repositioned at a greater depth. Repeat injection of local anesthetic clearly flowed around the nerve.