Journal of anesthesia
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Journal of anesthesia · Jan 2007
Case ReportsProlonged cardiac arrest unveiled silent sick sinus syndrome during general and epidural anesthesia.
Patients who have silent sick sinus syndrome (SSS) can show various unexpected arrhythmias during surgery. The severity of these bradyarrythmias is affected by anesthetic methods. We report a unique case of a patient with silent SSS who developed 40 s of asystole under combined general and epidural anesthesia. ⋯ During surgery, severe bradycardia, triggered by peritoneal manipulation, occurred, leading to 40 s of asystole. She was diagnosed as having SSS by a postoperative 24-h Holter electrocardiogram. We propose that the possible existence of SSS should be kept in mind even in a patient who shows no abnormalities on routine preoperative examination, especially in those in whom vagomimetic anesthetic methods are used.
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Journal of anesthesia · Jan 2007
Effects of nicardipine-induced hypotension on cerebrovascular carbon dioxide reactivity in patients with diabetes mellitus under sevoflurane anesthesia.
The purpose of this study was to examine the effects of nicardipine-induced hypotension on cerebrovascular CO2 reactivity in patients with diabetes mellitus under sevoflurane anesthesia. ⋯ We concluded that cerebrovascular CO2 reactivity in insulin-dependent patients is impaired during nicardipine-induced hypotension under sevoflurane anesthesia.
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Journal of anesthesia · Jan 2007
Case ReportsSedation for endoscopic retrograde cholangiopancreatography (ERCP) in a pregnant patient.
Anesthesiology management of endoscopic retrograde cholangiopancreatography (ERCP) in the twenty-first week of pregnancy of a woman patient is reported. The patient gave birth to a healthy male baby at 40 weeks of gestation.
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We report a case of pneumocephalus during continuous epidural infusion. A 52-year-old malnourished man with rectal cancer had been treated with continuous epidural block for the relief of pain in the left thigh. Eleven days after catheter insertion, a dull, persistent headache occurred in the frontal region, and it worsened gradually. ⋯ The catheter was removed and the patient maintained bed-rest. The headache disappeared 2 days later. It is speculated that the air was sucked in through the space along the epidural catheter.
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Journal of anesthesia · Jan 2007
Sevoflurane anesthesia did not affect postoperative cognitive dysfunction in patients undergoing coronary artery bypass graft surgery.
The purpose of this study was to retrospectively examine whether sevoflurane anesthesia had any ameliorative effects on postoperative cognitive dysfunction in patients undergoing coronary artery bypass graft (CABG) surgery. ⋯ This retrospective study showed no relationship between postoperative cognitive dysfunction and the use of sevoflurane.