Journal of anesthesia
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Journal of anesthesia · Apr 2020
Pre- and post-operative counseling for women on hormonal contraceptives receiving sugammadex at an academic hospital.
Sugammadex is a steroid binder and can potentially bind the estrogens and progestins contained within hormonal contraception. Therefore, the FDA label for sugammadex contains a drug-drug interaction warning between this medication and hormonal contraception, advising that women taking hormonal contraception use a backup contraceptive method or abstinence for seven days after exposure to sugammadex. However, given concerns that this warning may not be appropriately provided to at-risk patients, we conducted a retrospective chart review to identify women administered sugammadex while using hormonal contraception to identify documented counseling on this drug-drug interaction prior to implementation of a formalized counseling process. ⋯ We identified 134 women using hormonal contraception at the time of sugammadex exposure; only one patient (0.7%, 95% CI 0.0, 4.1) had documented counseling. One patient had an unintended pregnancy within the same cycle as her exposure to sugammadex. Improved counseling processes are needed to avoid unnecessary risk for unintended pregnancies.
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An endoscopic bite block is a device to ensure that the patient's mouth remains wide open during endoscopic procedures. Wide opening of the mouth may facilitate the efficiency of one-handed mask ventilation. We evaluated the effect of an endoscopic bite block on mask ventilation among three ventilation techniques: one-handed ventilation, one-handed ventilation with an endoscopic bite block, and two-handed ventilation. ⋯ The use of an endoscopic bite block improved one-handed mask ventilation, showing comparable efficacy with two-handed mask ventilation.
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Journal of anesthesia · Apr 2020
Randomized Controlled TrialProphylactic diphenhydramine attenuates postoperative catheter-related bladder discomfort in patients undergoing gynecologic laparoscopic surgery: a randomized double-blind clinical study.
To evaluate the effectiveness of diphenhydramine, an antihistamine with anti-muscarinic properties, for prevention of postoperative catheter-related bladder discomfort (CRBD). ⋯ Prophylactic diphenhydramine 30 mg at induction of general anesthesia reduced the incidence and severity of postoperative bladder discomfort without significant side effects in patients receiving gynecologic laparoscopic surgery.