Journal of clinical anesthesia
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Comparative Study Clinical Trial
Comparison of cisatracurium-induced neuromuscular blockade between immediate postpartum and nonpregnant patients.
To evaluate and compare cisatracurium-induced neuromuscular blockade and intubating conditions between immediate postpartum (PP) and nonpregnant (NP) patients. ⋯ This is the first published control study to compare the effects of cisatracurium between NP and PP patients. The results suggest that the mean onset time and clinical duration of cisatracurium are significantly shorter in immediate postpartum patients than those in nonpregnant female patients.
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To compare the cross-sectional area (in cm(2)) of the left internal jugular vein (LIJV) and right internal jugular vein (RIJV) in anesthetized children, and measure the response to the Trendelenburg tilt position (TBRG) and a positive inspiratory pressure hold. ⋯ The cross-sectional area of the RIJV is often greater than the LIJV; the TBRG was not effective to increase the cross-sectional area of the internal jugular veins, and only a PIP hold increased significantly the cross-sectional area of the RIJV. In this study, the LIJV appeared of smaller size and less compliant compared with the RIJV.
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A 31-year-old man with disseminated Coccidioides imitis infection required central catheter placement for access. The patient had an inferior vena cava (IVC) filter placed as a result of previous deep venous thrombosis of the left lower extremity. ⋯ Fluoroscopic examination revealed entanglement of the J-tip guidewire in the apex of the IVC filter. The catheter was successfully removed by interventional radiologists using a snare tip catheter through the left femoral vein.
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The perioperative use of neuraxial techniques in the presence of anticoagulation is a controversial issue. There are significant pharmacokinetic differences between anticoagulants that will affect the timing of neuraxial needle insertion or catheter removal. The pharmacologic profiles of commonly used anticoagulants in the perioperative period are reviewed. Studies examining the use of neuraxial techniques in the presence of various anticoagulants are reviewed and evaluated in the context of the American Society of Regional Anesthesia consensus statements.