Journal of clinical anesthesia
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Randomized Controlled Trial Clinical Trial
Patient-controlled bupivacaine wound instillation following cesarean section: the lack of efficacy of adjuvant ketamine.
To assess the analgesic efficacy of ketamine when administered as an adjuvant to bupivacaine for patient-controlled wound instillation following cesarean section. ⋯ Adjuvant local ketamine does not enhance bupivacaine-induced wound instillation following cesarean section.
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Use of single-dose and continuous interscalene brachial plexus block (ISB) are gaining widespread popularity. When compared with general anesthesia, ISB has been reported to provide superior postoperative analgesia with fewer side effects, and it is associated with greater patient satisfaction. Anatomical landmarks are readily identifiable, which contributes to the ease of performing this block. In the future, we anticipate increased use of continuous interscalene catheters or injection of biodegradable local anesthetic impregnated microspheres to provide prolonged perioperative outpatient analgesia.
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To evaluate whether preoperative blood volume and postoperative blood loss influence blood transfusion in females and males undergoing coronary artery bypass graft (CABG) surgery. ⋯ The greater need for blood transfusion in females than in males during CABG is primarily attributable to significantly lower preoperative total blood volume and RBC volume in females.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effect of laryngeal mask airway on esophageal motility during general anesthesia.
To determine whether the Laryngeal Mask Airway (LMA) triggers the pharyngo-esophago-gastric reflex during general anesthesia by comparing the esophageal motility of patients with the LMA and endotracheal tube (ETT) in place. ⋯ During the general anesthetic period before the arousal phase in this study, a LMA does not provoke significantly different esophageal peristalsis compared with an ETT. Thus, the LMA is unlikely to stimulate the pharyngo-esophago-gastric reflex during that period.
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We report the successful use of nalbuphine, a mu-receptor antagonist-kappa-receptor agonist, to reverse the adverse effects on the bladder of epidural morphine.