Journal of anesthesia
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Journal of anesthesia · Apr 2014
Randomized Controlled TrialInjection of intrathecal normal saline in decreasing postdural puncture headache.
Postdural puncture headache (PDPH) is the most common and still unresolved postoperative complication of spinal anesthesia. Although there are several positive results of intrathecal saline injection for the treatment of PDPH and prophylaxis after accidental dural puncture, the effect of deliberate intrathecal saline injection before spinal anesthesia has not been examined. The objective of our study was to evaluate the effect of prophylactic administration of intrathecal normal saline in decreasing PDPH. ⋯ Administration of normal saline (5 ml) before intrathecal administration of hyperbaric bupivacaine as a preventive approach is an effective and simple way to minimize PDPH in patients undergoing cesarean section.
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Journal of anesthesia · Apr 2014
Randomized Controlled TrialStroke volume-directed administration of hydroxyethyl starch (HES 130/0.4) and Ringer's acetate in prone position during neurosurgery: a randomized controlled trial.
General anesthesia in the prone position is associated with hypotension. We studied stroke volume (SV)-directed administration of hydroxyethyl starch (HES 130 kDa/0.4) and Ringer’s acetate (RAC) in neurosurgical patients operated on in a prone position to determine the volumes required for stable hemodynamics and possible coagulatory effects. ⋯ The amount of RAC needed in the prone position was 25 % greater. The cumulative dose of 440 ml HES induced a slight disturbance in fibrin formation and clot strength. We suggest cautious administration of HES during neurosurgery.
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Journal of anesthesia · Apr 2014
Randomized Controlled TrialKnee strength retention and analgesia with continuous perineural fentanyl infusion after total knee replacement: randomized controlled trial.
Despite providing adequate pain relief, a femoral nerve block can induce postoperative muscle weakness after total knee arthoplasty (TKA). Fentanyl has been shown to have peripheral effects but has not been used as a perineural infusate alone after TKA. ⋯ A continuous perineural infusion of fentanyl produced greater strength retention than ropivacaine post-TKA.