Anesthesia and analgesia
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Anesthesia and analgesia · Jul 2009
Case ReportsRefractory anaphylactic cardiac arrest after succinylcholine administration.
Refractory shock from anaphylaxis can occur after induction of general anesthesia. We report two cases of fatal cardiac arrest with increased blood tryptase and immunoglobulin E values after succinylcholine administration. Tryptase and immunoglobulin E assays may help to identify anaphylactic reactions when cardiac arrest occurs at induction of anesthesia.
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Anesthesia and analgesia · Jul 2009
Comparative StudyRegional blockade in patients with a history of a seizure disorder.
Systemic local anesthetic toxicity is a potential complication in patients undergoing regional anesthesia, particularly during procedures requiring large doses of local anesthetic, such as epidurals, caudals, and peripheral nerve blocks. It is unknown whether patients with a history of a seizure disorder are at an increased risk of central nervous system toxicity (seizures) after local anesthetic administration. ⋯ We conclude that majority of seizures occurring in the perioperative period in patients with a preexisting seizure disorder are likely related to the patient's underlying condition and that regional anesthesia in these patients is not contraindicated. Furthermore, because the likelihood of a postoperative seizure is increased in patients with a recent seizure, it is essential to be prepared to treat seizure activity, regardless of the anesthetic and analgesic technique.
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Anesthesia and analgesia · Jul 2009
Comparative StudyIntravascular flow patterns in transforaminal epidural injections: a comparative study of the cervical and lumbar vertebral segments.
Transforaminal epidural injection (TEI) is commonly used in the treatment of radicular pain. However, there have been many published cases of serious complications after a TEI, occurring most often in cervical levels. One of the presumptive reasons for this complication is inadvertent intravascular injection. We sought to identify the incidence of intravascular injections in cervical and lumbar spinal segments during TEI. ⋯ The incidence of vascular injection in CTEIs is significantly higher than in LTEIs, suggesting that CTEIs should be performed more cautiously. Furthermore, the vascular injection rate of CTEIs is much higher than that previously reported. This finding suggests the need for a proper volume of contrast injection (3 mL) to detect vascular flow, especially in simultaneous perineural and vascular injections.
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Anesthesia and analgesia · Jul 2009
Case ReportsCarotid dissection: a complication of internal jugular vein cannulation with the use of ultrasound.
Central venous catheters (CVCs) are often used in intensive care units and operating rooms. They facilitate hemodynamic monitoring, administration of fluids and medications, transvenous pacing and renal fluid replacement therapy. ⋯ We present an obese 66-yr-old man who had carotid artery dissection with compromised cerebral circulation after CVC insertion under ultrasound guidance. The dissection was immediately repaired with no neurological sequelae to the patient.
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Anesthesia and analgesia · Jul 2009
Randomized Controlled Trial Comparative StudyAn evaluation of the efficacy of licorice gargle for attenuating postoperative sore throat: a prospective, randomized, single-blind study.
Postoperative sore throat (POST) contributes to postoperative morbidity. Licorice has been used as an expectorant in cough and cold preparations. In this study, we evaluated the efficacy of licorice gargle for attenuating POST. ⋯ Licorice gargle performed 5 min before anesthesia is effective in attenuating the incidence and severity of POST.