Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Ketorolac or fentanyl to supplement local anesthesia?
To evaluate the usefulness of ketorolac in the treatment of intraoperative pain refractory to the administration of local anesthetic alone. ⋯ Ketorolac is a useful alternative to fentanyl for the treatment of intraoperative pain refractory to the administration of local anesthetic alone during monitored anesthesia care. A decided advantage of ketorolac over fentanyl is the absence of nausea and vomiting in the intraoperative and postoperative periods.
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Randomized Controlled Trial Comparative Study Clinical Trial
Patient-controlled drug administration during local anesthesia: a comparison of midazolam, propofol, and alfentanil.
To evaluate the perioperative effects of alfentanil, midazolam, and propofol when administered using a patient-controlled analgesia (PCA) device during local anesthesia. ⋯ When self-administered as adjuvants during local anesthesia using a PCA delivery system, alfentanil, midazolam, and propofol were equally acceptable to patients. However, propofol and midazolam were associated with fewer perioperative complications than was alfentanil.
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Review Case Reports
Intraoral vascular malformation and airway management: a case report and review of the literature.
A patient with a large airway venous malformation underwent anesthesia for a tooth extraction. The procedure was uneventful until extubation, immediately after which complete airway obstruction resulted. After unsuccessful attempts to relieve the problem, the patient's trachea was reintubated. ⋯ Anesthesiologists must be concerned with any airway vascular abnormality. Most abnormalities involving the airway are either hemangiomas or venous malformations. The anesthesiologist must diagnose the problem correctly because even minor manipulation of a venous malformation may result in exsanguination, or the malformation may become engorged and compromise the airway.
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Uterine inversion following vaginal delivery or during Cesarean section is rare. Cardiovascular instability resulting from blood loss is possible. This article describes the use of intravenous nitroglycerin as an alternative to the induction of general anesthesia and administration of volatile anesthetics to provide uterine relaxation.