Journal of clinical anesthesia
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We report a case of paradoxical presentation of a postural postdural puncture headache secondary to dural puncture with a 25-gauge Whitacre needle for combined spinal-epidural anesthesia. This 27-year-old female patient presented to the emergency department with elevated blood pressure and a global headache 9 days after administration of epidural anesthesia for a spontaneous vaginal delivery after an uncomplicated pregnancy. The patient reported that the headache was more intense when lying down and immediately improved when she sat or stood up from a recumbent position. The patient was discharged from emergency department after an improvement following treatment with labetalol, ondansetron, ketorolac, and fluid resuscitation.
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Clinical Trial
The impact of anesthesia on hemodynamic and volume changes in operative hysteroscopy: a bioimpedance randomized study.
Operative hysteroscopy is accompanied by the use of distention medium. Its absorption can lead to volume overload and hemodynamic disturbances that can lead to serious complications. We investigated the impact of the type of anesthesia on decreasing these complications with the use of noninvasive thoracic bioimpedance. ⋯ Spinal anesthesia is associated with less glycine absorption, less thoracic fluid load, better control of hemodynamics, and better patient satisfaction in operative hysteroscopy.
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Comparative Study
Pharmacokinetics and pharmacodynamics of cisatracurium in patients undergoing surgery with two hemodilution methods.
To investigate the pharmacokinetics and pharmacodynamics of cisatracurium in patients undergoing surgery under acute normovolemic hemodilution (ANH) and acute hypervolemic hemodilution (AHH). ⋯ When using cisatracurium under AHH, the dosage should be increased appropriately, while it need not be adjusted under ANH.