Journal of clinical anesthesia
-
Randomized Controlled Trial Comparative Study
Effect of tranexamic acid on reducing postoperative blood loss in combined hypotensive epidural anesthesia and general anesthesia for total hip replacement.
To determine whether the use of tranexamic acid in the setting of hypotension induced by hypotensive epidural anesthesia (HEA) has any additional beneficial effects in reducing perioperative blood loss and transfusion requirements in total hip replacement. ⋯ Administration of tranexamic acid combined with hypotensive epidural anesthesia reduced postoperative and total accumulative blood loss and transfusion requirements more than did hypotensive epidural anesthesia alone.
-
Comparative Study
Analgesia after Cesarean delivery: a retrospective comparison of intrathecal hydromorphone and morphine.
To compare analgesia and opioid-related side effects of intrathecal morphine and intrathecal hydromorphone after elective Cesarean delivery. ⋯ Overall, analgesia and incidence of opioid-related side effects after 0.04 mg of intrathecal hydromorphone did not differ statistically from 0.1 mg of intrathecal morphine.
-
To determine if health care providers at one district hospital in Nairobi, Kenya, possess the training and confidence necessary to attend to basic needs for patient resuscitation. ⋯ Providers of the Mbagathi District Hospital, Nairobi, report a lack of confidence in recognizing basic resuscitation needs, and they desire additional training.
-
Case Reports
Difficulty in placement of a left-sided double-lumen tube due to aberrant tracheobronchial anatomy.
A rare case of a tracheal bronchus coexisting with a left-shifted carina and an acute angle of left main bronchus is presented. A 66 year old man with a history of colon cancer was scheduled for right thoracoscopic pericardial window due to recurrent pericardial effusion. After induction of anesthesia, the trachea was intubated using a 39-French, left-sided double lumen tube (DLT); the DLT was positioned with fiberoptic bronchoscopic guidance. ⋯ While repositioning the DLT, we found an aberrant tracheal bronchus. Although multiple attempts were made to adjust the DLT so as to achieve lung isolation, we could not place the DLT in the appropriate position due to abnormal and distorted anatomy. Lung isolation was unsuccessful; both lungs were carefully ventilated with small tidal volumes.