Journal of clinical anesthesia
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Comparative Study
Comparison of stroke volume and fluid responsiveness measurements in commonly used technologies for goal-directed therapy.
To compare stroke volume (SV) and preload responsiveness measurements from different technologies with the esophageal Doppler monitor (EDM). ⋯ Stroke volume as measured by the FloTrac and LiDCOrapid systems does not correlate with the esphageal Doppler, has poor concordance, and a clinically unacceptable percentage error. The predictive value of the fluid responsiveness parameters is low, with only SVV measured by the LiDCOrapid having clinical utility.
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Randomized Controlled Trial
Ultrasound-guided bilateral transversus abdominis plane blocks in conjunction with intrathecal morphine for postcesarean analgesia.
To determine whether transversus abdominis plane (TAP) blocks administered in conjunction with intrathecal morphine provided superior analgesia to intrathecal morphine alone. ⋯ Transversus abdominis plane blocks in conjunction with intrathecal morphine provided superior early postcesarean analgesia to intrathecal morphine alone. By 24 hours there was no difference in pain scores or analgesic consumption.
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To describe the success and complication rate of intraosseous (IO) access for delivery of anesthesia with the use of an 18-gauge (G) intravenous (IV) needle. ⋯ The IO route provided for rapid delivery of anesthesia, induction, and maintenance in this series of critically ill infants undergoing emergency surgery when other vascular access routes failed. Few complications were noted. Intraosseous access was achieved through a simple technique using an 18-gauge IV needle.
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Case Reports
Transient hemidiaphragmatic paresis after ultrasound-guided lateral sagittal infraclavicular block.
As compared with medial approaches for the infraclavicular brachial plexus block, lateral approaches generally have no impact on the phrenic nerve or pulmonary function. A patient experienced transient hemidiaphragmatic paresis after ultrasound-guided lateral sagittal infraclavicular block for lower arm surgery. An accessory phrenic nerve, ie, an anatomical variation, may have been the mechanism of transient hemidiaphragmatic paresis in this patient.