Journal of clinical anesthesia
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A 23-year-old female was referred to the University of Arkansas for Medical Sciences at 32 weeks' gestation with a history of aortic stenosis following aortic valve replacement. Evaluation by echocardiography showed an approximately 90 mmHg transvalvular pressure gradient. ⋯ Invasive hemodynamic monitors were used to assess cardiac performance and as a guide for anesthetic management. The impact of aortic stenosis on pregnancy is discussed, as are management aspects of lumbar epidural anesthesia in such patients.
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Biography Historical Article
Crawford W. Long: pioneer physician in anesthesia.
Crawford W. Long first used ether as an anesthetic on March 30, 1842. This article examines factors in his education and practice that prompted his discovery. Included in the discussion are some of the circumstances that caused Long to delay publication of his experience with ether, as well as the impact of the "ether controversy" on his life.
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To delineate current practice with regard to how coagulation status is evaluated before induction of regional anesthesia in the preeclamptic parturient, with the goal of defining appropriate testing. ⋯ In the majority of academic programs in the United States, we found that the evaluation of coagulation status in the preeclamptic parturient was based primarily on a platelet count. A review of the literature supports this pattern of testing.
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Randomized Controlled Trial Clinical Trial
Headache prevention following accidental dural puncture in obstetric patients.
To evaluate the efficacy of a prophylactic saline patch and a prophylactic blood patch in prevention of headache following accidental dural puncture in obstetric patients. ⋯ The results of this study suggest that the administration of a prophylactic epidural blood patch is highly effective in the prevention of headaches following dural puncture, with headache frequency reduced from 87.5% to 5%.
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Randomized Controlled Trial Multicenter Study Clinical Trial
A randomized, double-blind pilot study examining the use of intravenous ondansetron in the prevention of postoperative nausea and vomiting in female inpatients.
To compare the efficacy and safety profiles of intravenous (IV) ondansetron (two 8 mg doses 8 hours apart) and a placebo when used in the prevention of postoperative nausea and emesis (vomiting or retching). ⋯ Prophylactic IV ondansetron appears to be safe and causes a significant reduction in the frequency and severity of postoperative nausea and emesis.