Acta clinica Croatica
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Trigeminal neuralgia causes severe to excruciating pain that often cannot be successfully reduced with current forms of treatment. The International Association for the Study of Pain (IASP) defines trigeminal neuralgia as a sudden, usually unilateral, powerful, short, stabbing, recurrent episode of pain in the distribution of one or more branches of the trigeminal nerve. Trigeminal neuralgia can be caused by vascular compression of the trigeminal nerve or a tumor process. ⋯ After diagnosing trigeminal neuralgia, magnetic resonance imaging should be performed to rule out multiple sclerosis, a tumor process that can secondarily cause trigeminal neuralgia. The drug of choice for treating trigeminal neuralgia is still carbamazepine. If pharmacological treatment fails, invasive surgical microvascular decompression, stereotactic radiation therapy (gamma knife), percutaneous balloon micro compression, percutaneous glycerol rhizolysis, and percutaneous radiofrequency (RF) may be used.
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Acta clinica Croatica · Sep 2022
ReviewPERIOPERATIVE PREPARATION OF CARDIAC PATIENTS IN REGIONAL ANESTHESIA.
Preoperative cardiovascular management is an essential component of overall perioperative cardiovascular care. It involves preoperative detection and management of cardiovascular disease and prediction of both short-term and long-term cardiovascular risk. ⋯ This requires individualized management. Careful preoperative preparation at least a week before surgery, rational decisions regarding necessary tests and examinations, good cooperation with the cardiologist and surgeon and careful planning of early postoperative treatment are key for better outcome after surgery and reduction of postoperative complications.
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Acta clinica Croatica · Sep 2022
HEMODYNAMIC FUNCTION IN COMPARISON OF TWO TYPES OF LOCAL ANESTHESIA WITH VASOCONSTRICTOR IN DAY SURGERY: RETROSPECTIVE STUDY.
Hemodynamic changes and cardiac arrhythmias are not uncommon in clinical practice, depending on including patient features, surgical treatment and drugs administered. We describe hemodynamic changes developed in young patients, soon after a local infiltration anesthesia in day surgery. ⋯ Measured transitory changes in heart rate and blood pressure after local infiltration of vasoconstrictor anesthetics in healthy patients prior to septorinoplasty and breast augmentation may be induced by endogenous and / or exogenous epinephrine. Bupivacaine solution for local infiltration analgesia reduces hemodynamic disturbances and prolongs analgesic effect. We highlight the need for careful preoperative evaluation, including anxiety assessment and treatment in all patients in day surgery.
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Acta clinica Croatica · Sep 2022
CLINICAL EFFECTS OF HYPERBARIC LIDOCAINE AND BUPIVACAINE IN SPINAL ANESTHESIA - OUR EXPERIENCE.
Various side effects and complications in the perioperative period can occur with the use of hyperbaric lidocaine and bupivacaine. ⋯ The compared incidence of adverse perioperative clinical effects and complications after administration of hyperbaric lidocaine and bupivacaine in spinal anesthesia was not statistically significant.
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Acta clinica Croatica · Sep 2022
CONVERSION RATE OF EPIDURAL ANALGESIA TO CAESAREAN SECTION REGIONAL OR GENERAL ANESTHESIA.
Epidural analgesia is acknowledged as the most common method of analgesia during labor. If emergent Caesarean section (CS) is indicated in parturient with existing labor epidural, the need for conversion from epidural analgesia to regional (RA) or general anesthesia (GA) increases accordingly. Recent guidelines suggest the rate of conversion to general anesthesia shows the quality of obstetric anesthesia care and should be under 5%. ⋯ In order to reach the required quality standards regarding the conversion rate from epidural analgesia to Caesarean section anesthesia, it is necessary to improve the organization of the work of the obstetric anesthesiology team according to the principle of subspecialization. It is imperative to implement the best clinical practice protocols for obstetric anesthesiologists, but also to enhance the communication and coordination with the obstetric team.