Anesthesia and analgesia
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Anesthesia and analgesia · Mar 2007
Perioperative complications in children with pulmonary hypertension undergoing noncardiac surgery or cardiac catheterization.
Pulmonary arterial hypertension (PAH) can lead to significant cardiac dysfunction and is considered to be associated with an increased risk of perioperative cardiovascular complications. ⋯ Children with suprasystemic PAH have a significant risk of major perioperative complications, including cardiac arrest and pulmonary hypertensive crisis.
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Anesthesia and analgesia · Mar 2007
A survey of the use of ultrasound during central venous catheterization.
Complications during central venous catheterization (CVC) are not rare and can be serious. The use of ultrasound (US) during CVC has been recommended to improve patient safety. We performed a survey to evaluate the frequency of, and factors influencing, US use. ⋯ The use of US during CVC remains limited and is most strongly associated with the availability of equipment. Screening and rescue use of US are more common than real-time guidance. Our survey suggests that current use of US during CVC differs from existing evidence-based recommendations.
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Anesthesia and analgesia · Mar 2007
Case ReportsUnrecognized contralateral intrapleural catheter: bilateral blockade may obscure detection of failed epidural catheterization.
Thoracic epidural analgesia has been widely used to reduce both postoperative and posttraumatic pain. We describe a case of inadvertent right-sided interpleural catheter placement and pneumothorax during attempted epidural catheter placement for left-sided rib fractures that went unrecognized because of bilateral blockade and adequate analgesia.
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Anesthesia and analgesia · Mar 2007
The effects of clonidine on postoperative analgesia after peripheral nerve blockade in children.
The effect of clonidine on the duration of sensory blockade after peripheral nerve blockade is controversial. We evaluated the effects of clonidine on the duration of sensory and motor block and analgesia time in children who underwent a variety of peripheral nerve blocks. ⋯ The addition of clonidine to bupivacaine and ropivacaine can extend sensory block by a few hours, and increase the incidence of motor blocks.