Journal of clinical anesthesia
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Brachial plexus blockade is a commonly used technique for providing surgical anesthesia for the upper extremity. Although various approaches have been described, the axillary approach is the safest and most frequently used. ⋯ A case of false aneurysm of the axillary artery following axillary nerve block is reported. The possible occurrence of this complication should be kept in mind to avoid permanent neurologic sequelae.
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Propofol was used for the induction and maintenance of anesthesia in a patient undergoing a laparoscopic tubal ligation. This new anesthetic has not been associated with postoperative ventricular arrhythmias. This report demonstrates the occurrence of supraventricular tachycardia deteriorating to ventricular tachycardia in a patient who received propofol. Included is a discussion of the possible causes of this event.
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Clinical Trial
Accelerated recovery from doxacurium-induced neuromuscular blockade in patients receiving chronic anticonvulsant therapy.
To determine whether a drug interaction exists between doxacurium and anticonvulsants. ⋯ Chronic treatment with anticonvulsants results in more rapid recovery from neuromuscular blockade produced by doxacurium.
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This report describes the case of an 80-year-old woman with a long history of chronic, stable angina pectoris who underwent resection of an abdominal aortic aneurysm and placement of an aortobifemoral bypass graft under a combination of epidural and general anesthesia. Epidural morphine was administered postoperatively for pain management. The patient suffered a massive myocardial infarction (MI) in the immediate postoperative period but experienced no chest pain or discomfort similar to her usual anginal symptoms. The use of epidural and spinal opioids in the treatment of anginal pain is reviewed and discussed in terms of the possibility that such epidural opioid therapy may have masked this patient's anginal symptoms.
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To determine the impact of a low fresh gas flow rate on the duration of carbon dioxide (CO2) absorption by soda lime. ⋯ Because soda lime color indicators are unreliable, when a semiclosed breathing circle is used at a low rate of fresh gas flow without CO2 monitoring, the CO2 absorbent must be replaced more frequently.