Journal of clinical anesthesia
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Randomized Controlled Trial Clinical Trial
Flow increases with an enlarging intravenous catheter.
To determine the increase in flow of a hydratable enlarging intravenous (IV) catheter in anesthetized patients. ⋯ Flow through enlarging IV catheters placed in anesthetized patients increases after 1 hour. The percentage increase in flow is not as great as previously seen in vitro and may be due to skin, vein, and subcutaneous tissues preventing complete expansion.
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Review Case Reports
Apparent focal motor seizure with a jacksonian march induced by fentanyl: a case report and review of the literature.
This report describes an unusual presentation of focal motor activity resembling Jacksonian march, which developed during fentanyl induction of general anesthesia. Simultaneous spectral-edge activity recording of electroencephalography (EEG) failed to show evidence of an epileptic focus. A negative history of previous seizures, as well as failure to show postoperative postictal symptoms or seizure activity by 16-lead EEG, suggested a myoclonic rather than epileptic nature of the observed muscle activity. Pertinent literature and current theories regarding opioid-induced seizures are discussed.
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Randomized Controlled Trial Clinical Trial
Facilitation of rapid-sequence intubation with large-dose vecuronium with or without priming.
To determine the effect of priming on the intubation and onset times of vecuronium 0.3 mg/kg. ⋯ Seventy-five percent to 85% neuromuscular block of the adductor pollicis, required for atraumatic tracheal intubation, developed in 80 seconds or less when vecuronium 0.3 mg/kg was administered in divided doses and in 140 seconds or less when it was injected as a single bolus dose. Clinical duration of vecuronium 0.3 mg/kg is long and unpredictable, and reversal of residual neuromuscular block may require larger doses of anticholinesterases. It is recommended that an intubating dose of vecuronium 0.3 mg/kg be used only in patients undergoing long surgical procedures that require prolonged postanesthetic mechanical ventilation.
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Editorial Comment
On the development of a new laser-resistant endotracheal tube.