Journal of clinical anesthesia
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Comparative Study Clinical Trial
A comparison of three techniques for acute postoperative pain control following major abdominal surgery.
To compare the analgesic efficacy of a nonsteroidal antiinflammatory drug (NSAID) alone (basic pain treatment) with that of NSAID in conjunction with either intravenous (IV) patient-controlled analgesia (IV-PCA) or intermittent epidural morphine (epidural morphine), among patients recovering from major intraabdominal surgery; and to assess the fixed and variable costs of providing the respective acute pain treatment modalities. ⋯ Considering the respective pain profiles, complication rates, and institutional costs associated with the three analgesic regimens analyzed, the basic pain Treatment alone constitutes a useful alternative to the other two analgesic regimens assessed.
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To examine whether increasing mean arterial pressure (MAP) with the administration of phenylephrine would improve internal jugular venous oxygen saturation (SjvO2) during normothermic cardiopulmonary bypass (CPB) in patients with preexisting stroke. ⋯ Increasing MAP improves SjvO2 in patients with or without preexisting stroke during normothermic CPB.
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Case Reports
An initially unnoticed piece of nasal jewelry in a parturient: implications for intraoperative airway management.
The literature documenting the anesthetic implications of body piercing consists only of a few case reports that focus exclusively on interference with airway management by oral jewelry. To date, no case reports documenting anesthetic problems resulting from the presence of nasal jewelry have been reported. ⋯ This situation necessitated fiberoptic examination of the nasopharyngeal and oropharyngeal cavities and radiologic imaging studies to rule out aerodigestive tract aspiration of retained and missing piece(s) of the jewelry. Based on this experience, we now advise all laboring parturients with nasal or oral jewelry in situ to remove the hardware on admission to Labor and Delivery for safety precautions.
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Randomized Controlled Trial Clinical Trial
Unilateral spinal block for outpatient knee arthroscopy: a dose-finding study.
To evaluate the onset time, success rate, and recovery profile of unilateral spinal anesthesia produced with 4 mg, 6 mg, and 8 mg of 0.5% hyperbaric bupivacaine. ⋯ Hyperbaric bupivacaine 4 mg injected slowly through pencil-point directional needles in patients who are maintained in the lateral decubitus position for 15 minutes provided a surgical block that was mostly restricted to the operative side and adequate to perform knee arthroscopy, with a faster recovery profile than when a 6 mg or 8 mg dose was used.
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Randomized Controlled Trial Clinical Trial
Tracheoscopy with the rapiscope to verify endotracheal tube placement.
To determine whether tracheoscopy is an accurate and quick method for verifying correct placement of the tracheal tube after intubation. ⋯ Tracheoscopy is a reliable method for quickly verifying proper endotracheal placement of a tracheal tube.