Journal of clinical anesthesia
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The prevalence of depression in patients with cardiovascular disease is higher than general population and especially following an acute coronary syndrome (ACS), a significant number of patients report a wide spectrum of behavioral and mood changes attributable to clinical depression. Treatment of depression following ACS event is particularly challenging since most of the therapeutic modalities are associated with increasing the systemic sympathetic tone from neurogenic or pharmacologic sources. Increased activity of the adrenergic and catecholamine activity may further deter the myocardial oxygen supply and demand therefore treating depression should be carefully evaluated for its risk benefit ratio. ⋯ Patients who refuse to take medications or present with any psychological emergency such as harming self or others, are also candidates for ECT. ECT is also associated with sudden surges of catecholamines and may cause recurrent myocardial ischemia and fatal dysrhythmias in patients convalescing from an ACS event. Herein, we provide an overview and practical guidelines for management of patients presented for ECT following ACS.
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Endotracheal intubation is considered the criterion-standard technique for securing the airway. Supraglottic airway devices (SADs) represent a major advance in airway management and are recommended by the guidelines in difficult situations such as Advanced Life Support and "cannot ventilate-cannot intubate" scenarios. The Easytube (EzT) is an SAD introduced a decade ago but not included yet in the above guidelines. ⋯ The EzT appears to be a safe and a good alternative to established SADs. It may be considered among SADs by future guidelines on Advanced Life Support and "cannot ventilate-cannot intubate" scenarios.
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As the patient population with deep brain stimulators grows, medical personnel need to be comfortable managing these patients because they will likely encounter them in practice. Caring for a patient with a deep brain stimulator during surgery or a procedure requires technical knowledge of the device and its possible interactions in order to take the correct precautionary measures. Here we discuss the key issues and questions that should be covered in every preanesthetic evaluation visit of a patient with a deep brain stimulator along with an evaluation checklist.
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To summarize and evaluate the available data describing the recovery parameters of xenon anesthesia. ⋯ This meta-analysis confirmed that recovery from xenon anesthesia is faster than other inhalation anesthesia.
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Review Meta Analysis Comparative Study
An estimation for an appropriate end time for an intraoperative intravenous lidocaine infusion in bowel surgery: a comparative meta-analysis.
There exists no commonly accepted regimen for an intravenous lidocaine infusion (IVLI). This study aims to determine an appropriate end time for an IVLI during bowel surgery. ⋯ Continuing an IVLI beyond 60 minutes after surgery has no added analgesic or gastrointestinal benefit. Further research is needed to clarify an optimal IVLI regimen and end time.