Journal of clinical anesthesia
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Fibrodysplasia ossificans progressiva (FOP) is a rare congenital disorder of connective tissue, which has significant implications on anesthetic management of affected patients, e.g., application of difficult airway algorithm, avoiding any trauma during venous cannulation. FOP has received very limited reviews in the published anesthesia literature. We describe perioperative care of a 21-year-old female with established diagnosis of FOP presenting for hysteroscopy followed by dilatation and curettage. Multiorgan abnormalities of FOP are reviewed and available anesthetic options are analyzed and compared.
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To determine anesthetic drug utilization in different age groups. ⋯ In clinical practice, increasing age results in decreased anesthetic drug administration. The mechanism of this observation needs to be determined.
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Case Reports
Recombinant factor VIIa for control of hemorrhage: early experience in critically ill trauma patients.
To examine our institutional experience with recombinant Factor VIIa (rFVIIa) as a treatment for exsanguinating hemorrhage in critically ill trauma patients. ⋯ Administration of rFVIIa shows promise in the treatment of exsanguinating hemorrhage. Prospective, controlled clinical trials of this therapy are strongly recommended.
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Case Reports
Horner's syndrome following very low concentration bupivacaine infusion for labor epidural analgesia.
Horner's syndrome is a complication of epidural analgesia and anesthesia, encountered more commonly in pregnant women than in other patients. Previous reports described the appearance of Horner's syndrome following epidural injection of concentrated local anesthetic solutions. We report unilateral Horner's syndrome occurring in the setting of lumbar epidural analgesia for labor with a very low local anesthetic concentration (bupivacaine 0.04%) in an epidural infusion. We discuss the possible factors that could have contributed to this occurrence despite the extremely dilute concentration of local anesthetic used for analgesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Ambulatory electrical external cardioversion with propofol or etomidate.
To compare, in pairwise fashion, the effects of propofol and etomidate during ambulatory cardioversion and early recovery. ⋯ Etomidate and propofol are both useful during ambulatory external electrical cardioversion. The described doses maintain stable hemodynamic conditions in nonpremedicated patients. Recovery scores and psychomotor test indicate a faster recovery in the propofol group. However, no intergroup differences were noted at 20 minutes after the cardioversion. A safe discharge of all patients from the critical care unit or postanesthesia care unit to the ward can be considered after 30 minutes.