Articles: postoperative-complications.
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The management of patients who require surgery while being treated with oral anticoagulants is a difficult balance between the risks of bleeding and those of recurrent thromboembolism. The urgency and the extent and site of surgery are important considerations, as are the strength of the indication for anticoagulants and the degree of anticoagulation. A practical approach is outlined for various situations that may be encountered.
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Of 128 patients receiving primary treatment for molar pregnancy at Women's Hospital, Los Angeles County/University of Southern California Medical Center, after uterine evacuation 12 (10.7%) developed self-limited, acute pulmonary complications characterized by tachycardia, tachypnea, and hypoxemia. Multiple contributing factors have been identified which include trophoblastic deportation, hyperthyroidism, fluid overload, dilutional anemia, and pre-eclampsia. ⋯ These patients are also at an increased risk for postmolar trophoblastic disease. The diagnosis and management of the postmolar pulmonary complications are discussed.
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Anesthesia and analgesia · Sep 1979
Comparative Study Clinical Trial Controlled Clinical TrialComparison of domperidone, droperidol, and metoclopramide in the prevention and treatment of nausea and vomiting after balanced general anesthesia.
Women (185) undergoing elective orthopedic surgery under balanced general anesthesia were given 5 or 10 mg of domperidone, 1.25 mg of droperidol, 10 mg of metoclopramide, or a saline placebo intravenously in a double-blind random fashion 5 minutes before the end of anesthesia to prevent postoperative vomiting. Administration of the same antiemetic was repeated intramuscularly during the first 24 hours postoperatively if the patient complained of nausea or retched or vomited. ⋯ Furthermore, 39 to 45% of the patients given domperidone, metoclopramide, or saline needed additional doses of the same drug, whereas only 22% of the patient given droperidol required a second dose. It is concluded that droperidol is effective in the prevention and treatment of postoperative nausea and vomiting after balanced general anesthesia but that domperidone or metoclopramide are not.
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Eight of twenty-six subjects undergoing cardiotomy had a diagnosable psychiatric syndrome after surgery. No difference between psychiatric and non-psychiatric cases was noted with respect to demographic data, pre-operative medical psychiatric history, anesthesia time, serial laboratory studies, or environment. Post-operative psychiatric cases, however, did have significantly higher exposure to psychoactive drugs during the pre- and post-operative period.