Journal of clinical anesthesia
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Clinical Trial Observational Study
Outpatient laparoscopic sleeve gastrectomy: first 100 cases.
The development of outpatient surgery was one of the major goals of public health policy in 2010. The purpose of this observational prospective study was to evaluate the feasibility of laparoscopic sleeve gastrectomy (SG) in an ambulatory setting. ⋯ Laparoscopic SG in an ambulatory setting is feasible with a dedicated anesthesiological approach and an expert surgical team. Appropriate patient selection is important for ensuring safety and quality of care within the outpatient program.
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The aim of this study was to establish the incidence of acute kidney injury (AKI) in patients undergoing elective hip and knee arthroplasty. ⋯ We identified stage 3 or higher CKD as a major risk factor for developing postoperative AKI. Preexisting CKD raised the risk of developing AKI 4-fold. We recommend that all patients undergoing lower limb arthroplasty should have renal function assessed preoperatively. In the perioperative period, renal function should be monitored in all patients. This is of particular importance in patients with estimated glomerular filtration rate <60.
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Microbial contamination during preparation of the infusion drugs is an important issue in intensive care units. Objective of this study was to investigate in vitro antimicrobial properties of commonly used vasoactive drugs. ⋯ To limit microbial growth in case of contamination of the drug solution, it is advisable to use more concentrated dilutions of adrenaline, noradrenaline, and dopamine used in clinical practice.
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Comparative Study
The effect of serratus plane block performed under direct vision on postoperative pain in breast surgery.
To determine the effectiveness of serratus plane block performed under direct vision on postoperative pain after mastectomy. ⋯ Serratus block provides effective regional anesthesia, suitable for mastectomies, and currently appears to be superior to wound infiltration alone. However, further data will need to be collected to support this finding.
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We present the case report of a 49-year-old gentleman with a history of adenoid cystic carcinoma of the left nare status post curative bifrontal craniotomy, left lateral rhinotomy and medial maxillectomy, adjuvant radiotherapy, and orbital exenteration for optic neuropathy, complicated by medial wall dehiscence. His course was also complicated by severe radiation trismus, for which he was scheduled to undergo bilateral mandibular coronoidectomies. ⋯ Because of concerns of traumatizing his nare, we utilized a flexible fiberoptic bronchoscope to perform asleep transorbital intubation. Airway management in patients with severe trismus may require ingenuity.