Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study
Comparison of posterior and subcostal approaches to ultrasound-guided transverse abdominis plane block for postoperative analgesia in laparoscopic cholecystectomy.
To evaluate the effectiveness of subcostal TAP block and to compare its efficacy with that of posterior TAP block in decreasing postoperative pain in patients undergoing laparoscopic cholecystectomy during general anesthesia. ⋯ For incisions mainly involving the supra-umbilical region, subcostal TAP block may be a better alternative than the posterior approach for providing postoperative analgesia.
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Review Case Reports
Broken spinal needle: case report and review of the literature.
The occurrence of broken spinal and epidural needles has been reported. However, most case reports have focused primarily on prevention rather than on management. A broken spinal needle fragment was left in a patient before it was removed one month later due to back pain.
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Randomized Controlled Trial
The effects of preoperative, video-assisted anesthesia education in Spanish on Spanish-speaking patients' anxiety, knowledge, and satisfaction: a pilot study.
We studied the effect of an instructional video in Spanish on self-reported anxiety, knowledge about general anesthesia procedures, and satisfaction with the preoperative anesthesia process in patients requiring a Spanish interpreter. This prospective, randomized, nonblinded pilot study took place at Massachusetts General Hospital (MGH), a university-affiliated tertiary-care hospital. Twenty adult, ASA physical status 1, 2, and 3 patients, scheduled for elective surgery (gynecological, orthopedic, and intrabdominal surgery) during general anesthesia were studied. ⋯ There was an increase in satisfaction score in the video group (median increase 2 vs 0; P = 0.046). There was no difference in reported knowledge-improvement scores between the two groups (3.5 vs 4; P = 0.908). In Spanish-speaking patients, the addition of an instructional video in Spanish to a preanesthesia interview decreased anxiety and increased patient satisfaction.
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To investigate the potential benefit of postoperatively providing a patient-controlled anxiolytic agent, midazolam, in addition to morphine. ⋯ Patients who received both midazolam and morphine experienced a more rapid decline in anxiety and used less opioid medication than those receiving morphine alone.