Journal of anesthesia
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Journal of anesthesia · Jan 2009
Randomized Controlled TrialEffects of adding magnesium to bupivacaine and fentanyl for spinal anesthesia in knee arthroscopy.
The aim of the study was to investigate the effects of adding intrathecal magnesium sulfate 50 mg to low-dose bupivacaine-fentanyl on the spread, duration, regression of spinal block, and postoperative analgesia in patients undergoing knee arthroscopy. ⋯ Even though the time to first analgesic requirement was prolonged significantly by magnesium, the addition of intrathecal magnesium sulfate to spinal anesthesia is not desirable in patients undergoing knee arthroscopy due to the prolonged time to ambulation and the lack of effect of magnesium on postoperative analgesic consumption.
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Journal of anesthesia · Jan 2009
Case ReportsCombination of oral ketamine and midazolam as a premedication for a severely autistic and combative patient.
Patients with impaired ability to understand and communicate can be difficult to manage perioperatively. They frequently require lateral thinking on the part of the anesthesiologists to make the induction process as smooth as possible. ⋯ A combination of oral ketamine and midazolam was mixed in the beverage Dr Pepper to mask the taste and the appearance of the drugs. The unique flavor of Dr Pepper is well suited to increase the palatibility and the acceptability of medications in children and patients with developmental delay.
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Journal of anesthesia · Jan 2009
Case ReportsAnesthetic management of renal transplantation in a patient with familial dysautonomia.
Familial dysautonomia is an inherited disorder characterized by autonomic and sensory nervous system neuropathy resulting in extremely labile blood pressure (severe hypertension followed by hypotension). As more patients with familial dysautonomia reach adulthood due to improved medical treatment, perioperative encounters of patients with familial dysautonomia will increase. This report is the first adult case to describe an anesthetic management of kidney transplantation for an adult familial dysautonomia patient. The clinical manifestations of this disease and rationale of our anesthetic management are discussed.
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Journal of anesthesia · Jan 2009
Randomized Controlled TrialPreoperative fluid and electrolyte management with oral rehydration therapy.
We hypothesized that oral rehydration therapy using an oral rehydration solution may be effective for preoperative fluid and electrolyte management in surgical patients before the induction of general anesthesia, and we investigated the safety and effectiveness of oral rehydration therapy as compared with intravenous therapy. ⋯ The results suggest that the oral rehydration therapy with an oral rehydration solution before surgery is superior to the current preoperative intravenous therapy for the provision of water, electrolytes, and carbohydrates, and this therapy should be considered as an alternative to the intravenous therapy for preoperative fluid and electrolyte management in selected surgical patients in whom there is no reason to suspect delayed gastric emptying.
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Journal of anesthesia · Jan 2009
Randomized Controlled Trial Comparative StudyIs there an advantage in using low-dose intrathecal bupivacaine for cesarean section?
Spinal anesthesia for cesarean section is associated with a high incidence of maternal hypotension. The aim of this study was to assess the efficacy of low-dose bupivacaine with fentanyl to reduce the incidence of hypotension in spinal anesthesia for cesarean section. ⋯ The development of hypotension after spinal block in subjects undergoing cesarean section was not prevented despite low-dose (4 mg) bupivacaine plus 25 microg fentanyl, but the severity of maternal hypotension, and the number of ephedrine treatments and the total dose of ephedrine were decreased.