Journal of clinical anesthesia
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This case report illustrates that median, radial, and ulnar nerve blocks at the elbow provides anesthesia for ambulatory carpal tunnel release surgery. This report discusses 3 patients with medical conditions, including vascular access problems and morbid obesity, which made nerve blocks at the elbow advantageous compared with other anesthetic techniques. ⋯ The blocks are easy to perform and set up quickly, and using long-acting local anesthetics, elbow blocks provide postoperative pain control for approximately 10 hours. The nerve blocks at the elbow facilitate the perioperative process by being done out of the operating room and providing prolonged pain control without the need for opioids, so nausea may be avoided.
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Randomized Controlled Trial
Advancing an epidural catheter 10 cm then retracting it 5 cm is no more effective than advancing it 5 cm.
To determine whether threading an epidural catheter 10 cm then retracting it 5 cm affects its intravascular placement and paresthesias. ⋯ There is no clear clinical benefit or disadvantage to threading an epidural catheter 10 cm into the epidural space then withdrawing it 5 cm. Further study is warranted.
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Randomized Controlled Trial Comparative Study
Effect of 2 anesthetic techniques on the postoperative proinflammatory and anti-inflammatory cytokine response and cellular immune function to minor surgery.
The aim of this study was to investigate the influence of 2 established anesthetic techniques: total intravenous anesthesia and balanced inhalation anesthesia (BAL) on the perioperative-induced changes of peripheral blood mononuclear cells (PBMCs), changes in lymphocyte subsets, and the balance of proinflammatory and anti-inflammatory cytokines. ⋯ Anesthetic management may have varying influences on the postoperative immune response. Surgery-induced inflammatory response and alteration in cell-mediated immunity seem to be more pronounced after BAL. These effects were attributed to the enhanced stress response after BAL.
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Randomized Controlled Trial Comparative Study
Comparison of conscious sedation for oocyte retrieval between low-anxiety and high-anxiety patients.
To investigate the correlation among the level of anxiety, the intravenous propofol requirement for conscious sedation, and recovery profile in in vitro fertilization patients. ⋯ The high-anxiety group needs more sedative requirement of propofol for conscious sedation than the low-anxiety group. Thus, we suggest that propofol dose for such sedation must take into account the individual patient's anxiety level when propofol is administered by an anesthesiologist for oocyte retrieval.
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Randomized Controlled Trial Comparative Study
Comparison of 2 concentrations of levobupivacaine in postoperative patient-controlled epidural analgesia.
To evaluate the quality of analgesia and the incidence of side effects of 2 different concentrations of levobupivacaine given as an equal milligram-bolus dose (5 mg) via patient-controlled epidural analgesia after abdominal surgery. ⋯ Administering the same dose of levobupivacaine in either a low or high concentration via patient-controlled epidural analgesia mode provides an equal quality of analgesia with no difference in the incidence of side effects.