Journal of clinical anesthesia
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Observational Study
Cardiac and hemodynamic consequences during capnoperitoneum and steep Trendelenburg positioning: lessons learned from robot-assisted laparoscopic prostatectomy.
To determine and interpret the changes in preload, afterload, and cardiac function in the different phases of robot-assisted laparoscopic prostatectomy. ⋯ Selective arterial vasodilation at the time of capnoperitoneum may normalize afterload and myocardial oxygen demand.
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There is an increase in the incidence of intraoperative fire in Indian hospitals. It is hypothesized that oxygen (O2) enrichment of air, is primarily responsible for most of the fires, particularly in intensive care units. ⋯ Indian hospitals need to make several changes in the arrangement of equipment and practice of handling O2 gas, as well as create awareness among hospital staff, doctors, and administrators. Recommendations for changes in system practice, which are in conformity with the National Fire Protection Association USA, are likely to be applicable in preventing fires at hospitals in all developing countries of the world with warm climates.
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Review Case Reports
West Nile virus infection and postoperative neurological symptoms: a case report and review of the literature.
The incidence of West Nile virus, which may cause a range of clinical presentations including subclinical infections, mild febrile illness, meningitis, or encephalitis, has increased over recent years. Rare complications, including optic neuritis, also have been reported. A patient who presented with preoperative asymptomatic West Nile virus developed fever, altered mental status and temporary vision loss after elective multilevel spine fusion surgery.
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We report an incident of delayed onset of true vocal fold paralysis with continuous interscalene brachial plexus block. A 51 year old woman underwent left shoulder manipulation and lysis of adhesions with fluoroscopy and general anesthesia. ⋯ The patient was admitted for observation and the catheter was discontinued with no intubation required. By the next morning, the patient's dysphagia and dyspnea had resolved and her hoarseness improved.
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To assess patients' knowledge of the role of the anesthesiologist and to identify information patients desire during the preoperative visit. ⋯ Despite the high level of education and health literacy in this group of patients, many were uninformed about the roles of anesthesiologists. Patients expressed interest in receiving a broad range of information during the preoperative visit. An educational booklet was the preferred method to provide this information.