Anesthesia and analgesia
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Anesthesia and analgesia · Feb 2008
Comparative StudyPractice patterns in choice of left double-lumen tube size for thoracic surgery.
Some anesthesiologists choose smaller than body size-appropriate left sided double-lumen tubes (DLTs) ("down-size") for lung isolation in an attempt to limit the risk of airway trauma. There are few data on the effects of DLT size on intraoperative outcome measures. ⋯ Under the conditions of this pilot study, the use of smaller than conventionally sized DLT was not associated with any differences in clinical intraoperative outcomes.
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Anesthesia and analgesia · Feb 2008
Biography Historical ArticleA tribute to Dr. Paul A. J. Janssen: entrepreneur extraordinaire, innovative scientist, and significant contributor to anesthesiology.
Dr. Paul Janssen was the founder of Janssen Pharmaceutica and the developer of over 80 pharmaceutical compounds that proved useful in human, botanical, and veterinary medicine. He and his coworkers synthesized the fentanyl family of drugs, many other potent analgesics, droperidol, etomidate, and numerous other important medicines that were extremely useful in psychiatry, parasitology, gastroenterology, cardiology, virology, and immunology. Anesthesiology and medicine as a whole have benefited a great deal from his resourcefulness, creativity, and entrepreneurial spirit.
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Anesthesia and analgesia · Feb 2008
Comparative StudyIdentification of the lumbar interspinous spaces: palpation versus ultrasound.
Palpation has been shown to be inaccurate at identifying lumbar interspinous spaces. Our goal in this study was to compare ultrasound imaging of the region to palpation. ⋯ There was poor agreement between palpation and ultrasound estimation of the specific lumbar interspace, and when there was disagreement, the ultrasound estimate was more often higher than the palpitation estimate.
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Anesthesia and analgesia · Feb 2008
Comparative StudyDoes sciatic parasacral injection spread to the obturator nerve? An anatomic study.
The ability of parasacral sciatic nerve block to provide consistent obturator nerve and perineal blockade remains undetermined. In this anatomic work, we assessed the spread of a colored latex mimicking a parasacral injection, and observed the spread to the obturator nerve and sacral nerve roots. ⋯ We conclude from this anatomical study that successful parasacral injection consistently spreads to the pelvic portion of the obturator nerve and to the sacral roots. Therefore, parasacral block should theoretically provide obturator and perineal blockade, and eliminate the need for systematic separate obturator nerve block. These results must be confirmed by further clinical studies.
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Anesthesia and analgesia · Feb 2008
Case ReportsOpioid-induced hyperalgesia and rapid opioid detoxification after tacrolimus administration.
Opioids can induce central sensitization and hyperalgesia, referred to as "opioid-induced hyperalgesia." Our report describes a patient who underwent intestinal transplant followed by immunosuppressant-related neuropathic pain. Her pain was treated with limited success over the course of 3 yr with different therapies, including i.v. morphine. ⋯ Six months after treatment, she remained opioid free. Our experience suggests that rapid detoxification under general anesthesia may be an effective treatment for opioid-induced hyperalgesia and merits comparison to traditional detoxification methods.