Journal of clinical anesthesia
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The prevalence of latex allergy is increasing in surgical patient populations. Avoidance of exposure to the allergen is essential to minimizing perioperative complications in patients suspected to be at risk. ⋯ However, the rubber stoppers commonly found in pharmaceutical vial closures are exempt from FDA labeling requirements. Examination of the clinical and basic science literature regarding pharmaceutical vial closures supports limiting the rubber stopper to a single needle puncture as a safer practice, with the caveat that no strategy exists for the complete elimination of risk as long as stoppers made from natural rubber latex are used in pharmaceutical vials intended for human use.
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The safety of patients and the health of clinicians are affected by drug and alcohol abuse. Affective disorders such as depression are also common in medical professionals, including anesthesiologists. The suicide rate among anesthesiologists is high. Since depression is the most common psychological characteristic associated with suicide, it may be a marker for risk of suicide.
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Although postoperative nerve injury is infrequent in patients undergoing joint replacement, it is extremely distressing for the patient, surgeon, and anesthesiologist. The nature of nerve injury is often closely related to the type of surgery; this review details the potential surgical causes of nerve injuries following total hip arthroplasty. The current orthopedic literature (1943-2008) was reviewed to help anesthesiologists better understand the pathophysiology of surgery-related postoperative nerve injuries, including the relationship with hip joint anatomy and the surgical techniques.
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To characterize the complications reported with intravenous regional anesthesia (IVRA). ⋯ Seizures have been reported with lidocaine at its lowest effective dose (1.5 mg/kg).
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The use of bronchoscopically placed self-expanding metallic stents (SEMS) and silastic stents in patients suffering from tracheobronchial stenosis or similar problems has proven to be an important clinical option. When complications occur, it may be necessary to remove the device. ⋯ Intubating patients' tracheas with a tracheal stent requires special caution, as it risks damaging tissue and dislodging the stent distally. Potential complications with removal include tracheal disruption, retained stent pieces, mucosal tears, re-obstruction requiring new stent placement, the need for postoperative ventilation, pneumothorax, damage to the pulmonary artery, and death.