Journal of clinical anesthesia
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Anterior spinal artery syndrome has rarely been reported as a cause of permanent neurologic complications after neuraxial anesthesia in obstetric patients. A parturient developed anterior spinal artery syndrome after spinal anesthesia for cesarean delivery. A healthy 32-year-old parturient presented at 41(2/7) weeks for primary elective caesarean delivery for breech presentation. ⋯ Intraoperative course was uneventful except for symptomatic bradycardia (37-40 beats per minute) and hypotension (88/44 mm Hg) 4 minutes postspinal anesthesia, treated with ephedrine and atropine. Dense motor block persisted 9 hours after spinal anesthesia, and magnetic resonance imaging of the lumbosacral region was normal, finding no spinal cord compression or lesion. Physical examination revealed deficits consistent with a spinal cord lesion at T6, impacting the anterior spinal cord while sparing the posterior tracts.
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Randomized Controlled Trial Comparative Study
Comparison of sugammadex and conventional reversal on postoperative nausea and vomiting: a randomized, blinded trial.
To determine whether the new selective binding agent sugammadex causes less postoperative nausea and vomiting (PONV) than the cholinesterase inhibitor neostigmine. ⋯ Nondepolarizing neuromuscular blocking antagonism with sugammadex speeds recovery of neuromuscular strength but only slightly and transiently reduces PONV compared with neostigmine and atropine.
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General anesthesia may lead in patients to unexpected and adverse reactions including toxicity. Glutathione S-transferases (GSTs) are enzymes responsible for the detoxification process of anesthetic agents. ⋯ The biochemical function and specific properties of GST render it a prognostic biomarker. This review demonstrates that GST can be valuable and promising toxicity indicator in patients undergoing general anesthesia.
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The aim of this study was to determine the independent factors associated with performance on the Maintenance of Certification in Anesthesiology Program (MOCA) examination. ⋯ Several factors in addition to performance on the written examination for primary certification (Part 1 Examination) are independently associated with performance on the MOCA examination. Because many of these factors are not modifiable, those diplomates who possess unfavorable risk factors should pay special attention to engaging in continuing learning to prepare for the MOCA examination.
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A 28-weeks gestation pregnant patient with chronic pacreatitis and severe abdominal pain leading to impaired nutrition is presented. After detailed consideration of the case, fluoroscopic-guided celiac plexus neurolysis was performed. The block was performed using the transaortic approach as it reduces radiation exposure.