Anesthesia and analgesia
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Anesthesia and analgesia · May 2008
Case ReportsSimulation education in anesthesia training: a case report of successful resuscitation of bupivacaine-induced cardiac arrest linked to recent simulation training.
Simulation training is rapidly becoming an integral element of the education curriculum of anesthesia residency programs. We report a case of successful resuscitation of bupivacaine-induced cardiac arrest treated with i.v. lipid emulsion by providers who had recently participated in simulation training involving a scenario nearly identical to this case. Upon debriefing, it was determined that the previous training influenced execution of the following steps: rapid problem recognition, prompt initiation of specific therapy in the setting of supportive advanced cardiac life support measures, and coordinated team efforts. Although the true cause of efficient resuscitation and ultimate recovery cannot be proven, the efficiency of the resuscitation process, including timely administration of lipid emulsion, is evidence that simulation may be useful for training providers to manage rare emergencies.
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Anesthesia and analgesia · May 2008
Comparative StudyEmulsified isoflurane produces cardiac protection after ischemia-reperfusion injury in rabbits.
In this study, we examined the cardioprotective effects of parental emulsified isoflurane compared with inhaled isoflurane. ⋯ Our results indicate that, in rabbits, i.v. emulsified isoflurane provides similar myocardial protection against ischemia-reperfusion injury as inhaled isoflurane.
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Anesthesia and analgesia · May 2008
Case ReportsFiberoptic intubation through an I-gel supraglottic airway in two patients with predicted difficult airway and intellectual disability.
We describe successful fiberoptic-guided tracheal intubation through the novel supraglottic "I-gel" airway in two uncooperative adult patients with genetic syndromes, learning disability, and predicted difficult airway, scheduled for complex dental treatment under general anesthesia. The I-gel maintained the airway immediately after induction, allowing oxygenation and ventilation. Location of the laryngeal inlet was successful on the first attempt with a fiberscope, and the tracheal tube was inserted into the trachea over the endoscope without complication in both patients. This report suggests another option for management of predicted difficult airways.
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Anesthesia and analgesia · May 2008
Sonographic estimation of needle depth for cervical epidural blocks.
Cervical epidural steroid injections are often used to treat acute and chronic pain syndromes involving the face, neck, and upper extremities. Ultrasound has evolved as a valuable tool for performing neuraxial blocks, providing useful prepuncture information on the structure. Our goal was to evaluate the accuracy and precision of ultrasound by comparing skin to dura distance from ultrasound with the actual skin to epidural depth. ⋯ Ultrasound provides very accurate information on the skin to dura distance for epidural blocks in the cervical spine. Knowledge of skin to dura distance and a preview of spinal anatomy before puncture can more safely identify the epidural space.
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Anesthesia and analgesia · May 2008
Comparative StudyPropranolol increases the threshold for lidocaine-induced convulsions in awake rats: a direct effect on the brain.
Propranolol is a beta-adrenoceptor antagonist used clinically. Local anesthetics are used for controlling pain, whereas propranolol is concomitantly given to treat hypertension and tachycardia. However, there are few studies examining the effects of propranolol on the toxicity of local anesthetics. We investigated the effect of propranolol on lidocaine-induced convulsions in awake, spontaneously breathing rats. ⋯ Propranolol increased the threshold for lidocaine-induced convulsions by directly acting on the brain.