Anesthesia and analgesia
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Anesthesia and analgesia · Jun 2007
Randomized Controlled Trial Comparative StudySpinal perianal block: a prospective, randomized, double-blind comparison with spinal saddle block.
In this prospective, randomized, double-blind study, we evaluated whether a very low dose of spinal bupivacaine could be sufficient for safe performance of short perianal surgery. ⋯ The use of 1.5 mg spinal bupivacaine can be successful for short perianal surgery.
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Anesthesia and analgesia · Jun 2007
Review Comparative StudySevoflurane: are there differences in products?
Sevoflurane is currently available in the United States from two manufacturers: Ultane (Abbott Laboratories, Inc.) and a generic product, Sevoflurane Inhalation Anesthetic (Baxter Healthcare Corp.). These products are rated therapeutically equivalent by the Food and Drug Administration, but there are some differences. ⋯ Ultane is supplied in a plastic polyethylene naphthalate polymer bottle, while generic sevoflurane is supplied in lacquer-lined aluminum bottles. The manufacturing processes and impurities, sevoflurane degradation resulting from Lewis acid reactions, and suitability of nonglass containers for sevoflurane are discussed.
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Anesthesia and analgesia · Jun 2007
Randomized Controlled Trial Comparative StudyThe coagulation changes induced by rapid in vivo crystalloid infusion are attenuated when magnesium is kept at the upper limit of normal.
Rapid crystalloid infusion enhances coagulation, regardless of electrolytes, pH or osmolality, an effect thought to be related to deep vein thrombosis and other clot formations. Altered serum magnesium may play a role in the balance of coagulation. In this in vivo study we investigated the coagulation response to rapid hemodilution when serum magnesium is maintained or partially increased. ⋯ Rapid hemodilution-induced coagulation may be partially due to decreased magnesium, and the effect is attenuated by maintaining magnesium at the upper limit of normal. Crystalloid resuscitation fluids should possibly contain higher magnesium levels, around 3 mmol/L.
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Anesthesia and analgesia · Jun 2007
Case ReportsSignificant hypoglycemia secondary to icodextrin peritoneal dialysate in a diabetic patient.
Icodextrin, a peritoneal dialysate commonly used in the renal failure patient with diabetes, may lead to an overestimation of blood glucose levels as determined by bedside glucometers. This spurious hyperglycemia can lead to significant morbidity if unrecognized. We describe a case of severe hypoglycemia caused by an unappreciated overestimation of blood glucose in a diabetic patient with concomitant chronic renal failure requiring peritoneal dialysis with icodextrin.
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Anesthesia and analgesia · Jun 2007
Comparative StudyComplications and adverse effects associated with continuous peripheral nerve blocks in orthopedic patients.
The increasing popularity of continuous peripheral nerve blocks (CPNBs) warrants further study of their adverse effects and complications. ⋯ Our results add to the evidence that major complications from CPNBs are rare. However, minor adverse effects associated with CPNBs may be more common.