Journal of clinical anesthesia
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To estimate the magnitude behavior of ferrous-alloy, wire-reinforced microcatheters for subarachnoid anesthesia and the possible hazards of exposing patients to magnetic resonance imaging (MRI) after accidental catheter fracture within the subarachnoid space. ⋯ The microcatheters under test exhibited marked magnetic properties. Two questions arise: First, should MRI be avoided in patients where broken TFX catheter fragments may lie partly or completely within the subarachnoid space? Second, should ferrous metallic strengthening wire be replaced by a nonmetallic fiber of comparable or greater tensile strength? Further in vitro studies are indicated to answer these questions.
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Randomized Controlled Trial Clinical Trial
Intraocular pressure and hemodynamic changes following tracheal intubation in children.
To determine the optimal time in which to make intraocular pressure (IOP) measurements in children following tracheal intubation. ⋯ We recommend that IOP be measured only after HR and MAP have returned to preintubation levels in children who have undergone tracheal intubation during halothane and N2O anesthesia.
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Case Reports
Pulmonary edema and coagulopathy following intrauterine instillation of 32% dextran-70 (Hyskon).
Hysteroscopy using 32% Dextran-70 in 10% dextrose (Hyskon) is a common outpatient procedure. We report a case of pulmonary edema and coagulopathy in a 38-year-old, 48 kg female who had hysteroscopy and removal of an endocervical polyp using 700 ml of Hyskon over a 2-hour period. Low percutaneous oxygen saturation (SpO2) and vaginal bleeding developed postoperatively. ⋯ The patient developed overt pulmonary edema following the hysterectomy and was treated with positive pressure ventilation. The pathophysiology for the development of pulmonary edema and coagulopathy is discussed. Recommended limits for Hyskon volumes and instillation times are emphasized, as is careful recording of these parameters.
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To determine retrospectively the effect of high-dose opiate-oxygen (O2) anesthetic technique on intraoperative ventricular fibrillation in high-risk neonates. ⋯ High-dose opiate-O2 anesthesia in these patients markedly decreased intraoperative ventricular fibrillation. Other clinical reports and recent experimental work suggest that this finding is due to high-dose opiates rather than the avoidance of N2O.