Journal of clinical anesthesia
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Editorial Comment
Anesthetic management of the drug-abusing parturient: are you ready?
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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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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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Beta-adrenergic agents have been widely used in obstetrics to attenuate premature labor (termed tocolytic therapy), delay delivery, allow fetal maturation, and thereby reduce neonatal morbidity and mortality. Hypokalemia is a common side effect during beta-adrenergic tocolytic therapy for the treatment of preterm labor. Although rebound hyperkalemia after cessation of tocolytic therapy with ritodrine has been reported, there have been no reports of hyperkalemia occurring after the cessation of beta-adrenergic tocolytic therapy with terbutaline for preterm labor; we report such a case.