Journal of clinical anesthesia
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To investigate the effects of dexmedetomidine on oxidative injury caused by ionizing radiation. ⋯ Dexmedetomidine preserves the antioxidant enzyme levels and reduces toxic oxidant metabolites. Therefore, it can provide protection from oxidative injury caused by ionizing radiation.
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Letter Case Reports
Anesthesia-airway management in a newborn with syngnathia.
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To determine perioperative treatments and events associated with Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) responses among patients who undergo total hip arthroplasties (THAs) and total knee arthroplasties (TKAs). ⋯ These data suggest that chronic use of nonsteroidal anti-inflammatory drugs is associated with improved overall satisfaction and satisfaction with pain in THA patients. Furthermore, increased PACU opioid use was negatively associated satisfaction with pain management. Age, lengths of stay preadmission medications, anxiolytic medications, and PACU pain scores are associated with patient satisfaction with regards to both pain management and overall satisfaction in TKA patients.
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Observational Study
An in vitro evaluation of the pressure generated during programmed intermittent epidural bolus injection at varying infusion delivery speeds.
Programmed intermittent bolus injection of epidural anesthetic solution results in decreased anesthetic consumption and better patient satisfaction compared with continuous infusion, presumably by better spread of the anesthetic solution in the epidural space. It is not known whether the delivery speed of the bolus injection influences analgesia outcomes. The objective of this in vitro study was to determine the pressure generated by a programmed intermittent bolus pump at 4 infusion delivery speeds through open-ended, single-orifice and closed-end, multiorifice epidural catheters. ⋯ Using a pump designed for programmed intermittent infusion boluses, the delivery speed of saline solution through epidural catheters was directly related to the peak pressures. Future work should evaluate whether differences in the delivery speed of anesthetic solution into the epidural space correlate with differences in the duration and quality of analgesia during programmed intermittent epidural bolus delivery.
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Case Reports
Successful recovery after amniotic fluid embolism in a patient undergoing vacuum-assisted vaginal delivery.
Amniotic fluid embolism (AFE) is a rare, catastrophic emergency that requires prompt recognition and treatment. Despite early recognition and supportive therapy, the morbidity and mortality remain high. We report a case of AFE after vacuum-assisted vaginal delivery resulting in hemodynamic collapse and subsequent multiorgan failure. ⋯ The patient was able to make a full recovery with minimal sequelae. In AFE with multiorgan failure, extracorporeal membrane oxygenation and continuous veno-venous hemodialysis can be valuable therapies. Proper management requires effective communication and the combined efforts of physicians of several disciplines.