The Yale journal of biology and medicine
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We have previously reported a standardized 10-step sequence of monoplane (transverse plane) transesophageal two-dimensional echocardiographic views and a standardized 7-step vertical plane examination, both suitable for expeditious intraoperative use by the beginning practitioner. A multiplane transesophageal examination involves transverse plane views, vertical plane views and the remaining "in-between" oblique plane views. ⋯ Each of these steps is illustrated with a two-dimensional echocardiographic image, a matching diagram and a schematic representation of the corresponding axis of interrogation. This description of oblique plane imaging, therefore, completes the components of a multiplane transesophageal examination.
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Many variations to the axillary approach to the brachial plexus have been described. However, the success rate varies depending on the approach used and on the definition of success. Recent work describes a new approach to regional anaesthesia of the upper limb at the humeral/brachial canal using selective stimulation of the major nerves. ⋯ No complications were described. Initial experience confirms the high success rate described using the Dupré technique. This technically straightforward approach with minimal complications can be recommended for regional anaesthesia of the upper limb.
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Review Comparative Study
Anesthetic implications of laparoscopic surgery.
Minimally invasive therapy aims to minimize the trauma of any interventional process but still achieve a satisfactory therapeutic result. The development of "critical pathways," rapid mobilization and early feeding have contributed towards the goal of shorter hospital stay. This concept has been extended to include laparoscopic cholecystectomy and hernia repair. ⋯ NSAIDs to attenuate peripheral pain and opioids for central pain may reduce postoperative discomfort and expedite patient recovery/discharge. There is no conclusive evidence to demonstrate clinically significant effects of nitrous oxide on surgical conditions during laparoscopic cholecystectomy or on the incidence of postoperative emesis. Laparoscopic cholecystectomy has proven to be a major advance in the treatment of patients with symptomatic gallbladder disease.