Journal of clinical anesthesia
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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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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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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.
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Several potential complications may occur during identification of the epidural space. We present a case of subarachnoid pneumocephalus as a rare complication of epidural catheter placement.