British journal of anaesthesia
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We present the cases of three women who, within a 6-month period, suffered post-partum generalized tonic-clonic seizures. All had received an epidural in labour for analgesia and were subsequently diagnosed as suffering from postdural puncture headache. ⋯ All made satisfactory recoveries and were discharged home. None displayed classical patterns suggestive of pre-eclampsia, meningitis, cortical venous thrombosis or any other pathological process that might explain these events adequately, and the specific precipitating factors were left unidentified.
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There has been recent concern in the media over the possible detrimental effects of herbal medicines on the perioperative period. Perceived by the public as 'natural' and therefore safe, herbal remedies may have led to adverse events such as myocardial infarction, bleeding, prolonged or inadequate anaesthesia and rejection of transplanted organs. In addition, herbal remedies can interact with many drugs given in the perioperative period. In this article we summarize the potential perioperative complications that can occur. ⋯ Self-administration of herbal medicines is common in patients presenting for anaesthesia. Because of the potential for side-effects and drug interactions it is important for anaesthetists to be aware of their use.
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Several attempts have been made to evaluate patients' concerns with respect to postoperative recovery. To identify aspects of postoperative recovery relevant to patients, several methodological and statistical approaches have been used. One of the first to provide useful information was Fredrick Orkin who used conjoint analysis. This methodology is usually performed by market researchers to learn about the relative importance of product attributes. We used conjoint analysis in the present study. ⋯ Avoidance of PONV is a major concern for patients before surgery.
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There is little advice on the posture to be used when intubating the trachea. Does the stance used depend on experience? ⋯ Novice anaesthetists should be given explicit instructions on correct trolley height and should be taught to intubate with a straight back.