Anesthesia and analgesia
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Anesthesia and analgesia · Oct 2009
Case ReportsDelayed quadriparesis after an interscalene brachial plexus block and general anesthesia: a differential diagnosis.
Interscalene brachial plexus block has been widely used for upper limb surgery. Different neurological complications related to this technique have been published. ⋯ Central progression of an interscalene block can produce acute or subacute quadriparesis depending on technical factors of the placement of the local anesthetic and its subsequent spread. The symptomatology and the imaging enabled us to refine the differential diagnoses and to exclude other causes of neurologic compromise.
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Anesthesia and analgesia · Oct 2009
Randomized Controlled Trial Comparative StudyThe analgesic effect of paracetamol when added to lidocaine for intravenous regional anesthesia.
In this study, we evaluated the effect of paracetamol on sensory and motor block onset time, tourniquet pain, and postoperative analgesia, when added to lidocaine in IV regional anesthesia (IVRA). ⋯ The addition of paracetamol during IVRA with lidocaine decreased tourniquet pain, increased anesthesia quality, and decreased postoperative analgesic consumption.
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Anesthesia and analgesia · Oct 2009
Comparative StudyThe effects of cardiopulmonary bypass on the number of cerebral microemboli and the incidence of cognitive dysfunction after coronary artery bypass graft surgery.
Postoperative cognitive dysfunction (POCD) can be a debilitating complication after coronary artery bypass graft (CABG) surgery. Cerebral microemboli during cardiopulmonary bypass (CPB) are believed to be an important etiologic factor of POCD. In this study, we examined whether avoidance of CPB with "off-pump" surgery reduces the number of cerebral microemboli and the incidence of POCD after CABG surgery in Chinese population. ⋯ In Chinese population, avoidance of CPB during CABG surgery significantly decreased the number of cerebral microemboli, but it did not decrease the incidence of POCD at either 1 wk or 3 mo after CABG. Neither CPB nor cerebral microemboli was independently associated with the risk of POCD.
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Anesthesia and analgesia · Oct 2009
Obstructive sleep apnea is not a risk factor for difficult intubation in morbidly obese patients.
Morbid obesity (MO), obstructive sleep apnea (OSA), and neck circumference (NC) are widely believed to be independent risk factors for difficult tracheal intubation. In this study, we sought to determine whether these factors were associated with increased risk of difficult intubation in patients undergoing bariatric surgery. The predictive factors tested were OSA and its severity, as determined by apnea-hypopnea index (AHI), gender, NC, and body mass index (BMI). ⋯ In MO patients undergoing bariatric surgery in the "ramped position," there was no relationship between the presence and severity of OSA, BMI, or NC and difficulty of intubation or laryngoscopy grade. Only a Mallampati score of 3 or 4 or male gender predicted difficult intubation.
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Anesthesia and analgesia · Oct 2009
A prediction model for out-of-hospital cardiopulmonary resuscitation.
We created a prediction model to be used in cardiopulmonary resuscitation (CPR) attempts as a decision tool to omit futile CPR attempts and to save resources. ⋯ For out-of-hospital patients with cardiac arrest, parameters documented in the field did not allow accurate prediction of hospital survival.