Journal of clinical anesthesia
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Randomized Controlled Trial Clinical Trial
Fentanyl-induced muscle rigidity as affected by pretreatment with amantadine hydrochloride.
To determine whether the degree of muscle rigidity in humans caused by the administration of high-dose fentanyl is affected by pretreatment with amantadine hydrochloride, a drug that stimulates the release of dopamine in the basal ganglia. ⋯ Muscle rigidity associated with the administration of high-dose fentanyl is not attenuated by prior administration of amantadine in the dose range studied.
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Randomized Controlled Trial Clinical Trial
Lidocaine blood levels following aerosolization and intravenous administration.
To determine whether, following aerosolization of lidocaine for topical airway anesthesia, intravenous (IV) lidocaine produces toxic lidocaine blood concentrations. ⋯ IV lidocaine can be safely administered following aerosolization of lidocaine in spontaneously breathing patients without producing toxic blood lidocaine concentrations.
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Unilateral phrenic nerve block is common after supraclavicular brachial plexus block techniques, although it is rarely symptomatic in patients without respiratory disease. A 24-weeks-pregnant woman was scheduled for a carpal tunnel release because of intractable pain. ⋯ Respiratory changes produced by pregnancy might compromise ventilatory reserve. Thus, we suggest avoiding supraclavicular approaches to brachial plexus block in pregnant women, since they may be as prone to developing respiratory embarrassment, secondary to phrenic block, as patients with pulmonary pathology.
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Randomized Controlled Trial Clinical Trial
Epidural opioids during laminectomy surgery for postoperative pain.
To determine whether morphine applied directly to the dura during laminectomy surgery provides superior postoperative analgesia during the first 24 hours. ⋯ Morphine 3 mg applied topically to the dura at the end of laminectomy surgery is a simple, safe, and effective way of providing improved postoperative analgesia.
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To evaluate the clinical use of a cardiorespiratory rate monitor in patients receiving epidural opioids following major surgery. ⋯ The cardiorespiratory rate monitor is useful in patients at risk for bradypnea following surgery.