Journal of clinical anesthesia
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Randomized Controlled Trial Clinical Trial
Effect of epidural morphine on sedation requirements during regional anesthesia.
To examine the effect of using analgesic doses of epidural morphine on midazolam requirements for conscious sedation during regional anesthesia. ⋯ An analgesic dose of epidural morphine, after a latent period of 3 hours, may decrease the dose of midazolam required for sedation using regional anesthesia.
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Case Reports
Cardiopulmonary arrest in the pregnant patient: a report of a successful resuscitation.
We report the case of a pregnant patient who suffered cardiac arrest and was initially unresponsive to resuscitative measures. Prompt emergent cesarean delivery of the infant was carried out, and both mother and infant were then successfully resuscitated. We believe that prompt cesarean delivery is the key to maternal and infant survival in such cases.
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Randomized Controlled Trial Comparative Study Clinical Trial
Intercostal nerve block for lumpectomy: superior postoperative pain relief with bupivacaine.
To investigate whether equipotent doses of lidocaine and bupivacaine were equally effective for intercoastal nerve blockade (ICNB) and whether a lower amount of lidocaine would be comparably effective. To see whether plasma levels of lidocaine with and without epinephrine and of plain bupivacaine would reach toxic ranges. Finally, to evaluate the duration of postoperative analgesia following general anesthesia and regional anesthesia with two different local anesthetics. ⋯ ICNB is an alternative to general anesthesia for female breast surgery. Both lidocaine with epinephrine and plain bupivacaine in the doses used did not raise venous plasma concentrations to levels considered potentially toxic. With respect to duration of postoperative pain relief and analgesic drug request, the local anesthetics (in particular, bupivacaine) were found to be superior to general anesthesia.
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Randomized Controlled Trial Clinical Trial
Intravenous ketorolac as an adjunct to patient-controlled analgesia (PCA) for management of postgynecologic surgical pain.
To determine whether intravenous (IV) doses of ketorolac tromethamine provide safe and effective augmentation of postsurgical analgesia for patients using IV patient-controlled analgesia (PCA) with morphine. ⋯ IV ketorolac used as an analgesic adjunct provided safe and effective augmentation of PCA with morphine in patients recovering from intra-abdominal gynecologic surgery.
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Randomized Controlled Trial Comparative Study Clinical Trial
The frequency of postdural puncture headache in obstetric patients: a prospective study comparing the 24-gauge versus the 22-gauge Sprotte needle.
To compare the frequency of postdural puncture headache (PDPH) in obstetric patients when using the 24-gauge or the larger 22-gauge Sprotte needle. ⋯ Our results suggest that the 22-gauge Sprotte needle, when compared with the smaller 24-gauge Sprotte needle, can be used in obstetric patients without increasing the frequency of PDPH.