Journal of clinical anesthesia
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Criteria for determination of brain death in adults have been defined. Spinal cord reflexes may persist after brain death. We present the case of a brain dead patient who had a complex spinal automatism resulting in head shaking and arm extension. The report reviews guidelines for the diagnosis of brain death and discusses complex spinal cord reflexes in brain dead patients.
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We present 12 case reports from patients treated with more than 600 mg of morphine per day. We found no "opioid-nonresponsive pain" under treatment with a combination of morphine and nonopioids, supplemented with coanalgesics where appropriate. ⋯ Serious adverse effects were not observed. Episodes of break-through pain, dysphagia, and dyspnea caused by far advanced cancer disease were seen frequently.
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Randomized Controlled Trial Comparative Study Clinical Trial
Patient-controlled analgesia with sufentanil: a comparison of two different methods of administration.
To examine the safety and analgesic efficacy of sufentanil administered via either epidural or intravenous (i.v.) patient-controlled analgesia (PCA) in patients recovering from gynecologic surgery. ⋯ The main advantage of EPCA sufentanil in this postsurgical setting was its ability to provide a more rapid onset of analgesia than traditional i.v. PCA with morphine while offering greater safety than i.v. sufentanil.
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Clinical Trial Controlled Clinical Trial
Hemodynamic effects of intrathecal fentanyl in nonlaboring term parturients.
To determine the effect of intrathecal fentanyl on maternal hemodynamics. ⋯ Intrathecal administration of fentanyl 25 micrograms in nonlaboring term parturients does not produce clinically important maternal hemodynamic changes.
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Comparative Study Clinical Trial
Bowel function recovery after radical hysterectomies: thoracic epidural bupivacaine-morphine versus intravenous patient-controlled analgesia with morphine: a pilot study.
To determine if the use of continuous epidural bupivacaine-morphine in the perioperative period is associated with a significant decrease in the recovery time of postoperative ileus when compared with parenteral morphine administration. ⋯ The use of thoracic epidural bupivacaine-morphine results in a decrease in the duration of postoperative ileus, which was associated with earlier hospital discharge.