Journal of clinical anesthesia
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To investigate the difference of regional cerebral oxygen saturation (rSo2) decrease in response to the decrease in mean arterial blood pressure (MAP) in young and elderly patients. ⋯ After propofol induction, there was no difference between young and elderly patients in rSo2 decrease in response to the decrease in MAP.
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We report a case of subdural hematoma in a 68-year-old white man who underwent left inguinal hernia repair with spinal anesthesia. The patient had a postdural puncture headache (PDPH) on postoperative day 4, but he refused invasive treatment. Instead, he self-administered acetaminophen, aspirin, and caffeine. ⋯ Immediate treatment of the PDPH with an epidural blood patch should be considered. If a patient refuses invasive treatment, he should be counseled for the possibility of subdural hematoma. The patient also should be advised to avoid medications with anticoagulant properties.
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Randomized Controlled Trial Clinical Trial
Epidural analgesia improves early rehabilitation after total knee replacement.
To compare epidural anesthesia and analgesia with spinal anesthesia with intravenous morphine analgesia for its effect on range of motion (ROM) and early rehabilitation after total knee replacement. ⋯ By using epidural analgesia in the first 7 days postoperatively, we achieved improved early rehabilitation due to excellent pain relief effect and an antithrombotic effect with an efficacy comparable to low molecular-weight heparin.
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Launois-Bensaude syndrome, otherwise known as Madelung's disease, is a rare disorder characterized by fatty accumulations of the upper trunk, neck and head, causing serious cosmetic deformity and neck immobility. We report a case of a patient with Launois-Bensaude syndrome who required 4 different airway management strategies during his hospitalization for postoperative complications after an elective surgical excision of a severe neck lipomatosis. Anesthesiologists who treat patients with Madelung's disease should be aware of 2 major problems: difficult airway and increased frequency of postoperative bleeding. A proper choice of airway management technique is therefore necessary, including a safe intubation and extubation plan to reduce the consequences of airway complications.
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Randomized Controlled Trial Clinical Trial
Morphine sparing with droperidol in patient-controlled analgesia.
To determine if droperidol has a morphine-sparing effect when coadministered with morphine via patient-controlled analgesia (PCA) for postoperative pain management. ⋯ Coadministration of 50 mug droperidol and 1 mg morphine on demand via PCA provides a morphine-sparing effect and reduces the frequency of postoperative nausea and vomiting.