Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Additional droperidol, not butorphanol, augments epidural fentanyl analgesia following anorectal surgery.
To examine the effects of additional droperidol or butorphanol to epidural fentanyl infusion on postsurgical analgesia. ⋯ In this study population, additional droperidol, not butorphanol, improved postsurgical analgesia accompanied by less incidence of nausea/vomiting during epidural fentanyl administration.
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Case Reports
Complex regional pain syndrome (CRPS) with resistance to local anesthetic block: a case report.
We present a case of complex regional pain syndrome (CRPS) Type 1 in a 12-year-old girl. The patient did not respond to the usual therapeutic modalities used to treat CRPS, including physical therapy, lumbar sympathetic block, epidural local anesthetic block, intravenous lidocaine infusion, or other oral medications. Of note is the fact that, during epidural block, the patient demonstrated a resistance to local anesthetic neural blockade in the area of the body involved with the pain problem. The mechanism of this resistance could be related to the changes in the dorsal horn cells of the spinal cord, secondary to activation of N-methyl-D-aspartate receptors, which may play a role in the pathophysiology of this pain syndrome.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Pooled analysis of three large clinical trials to determine the optimal dose of dolasetron mesylate needed to prevent postoperative nausea and vomiting. The Dolasetron Prophylaxis Study Group.
To identify the maximally effective dolasetron dose (i.e., maximum efficacy with minimum adverse events) for prevention of postoperative nausea and vomiting (PONV) using the statistical power generated in a pooled patient sample from three large, nearly identical clinical trials. ⋯ Dolasetron 12.5 mg, given near the end of anesthesia, is the maximally effective dose studied for preventing postoperative nausea and vomiting.
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Comparative Study
Improved flow and pressure capabilities of the Datex-Ohmeda SmartVent anesthesia ventilator.
To compare the flow and pressure capabilities of the Datex-Ohmeda SmartVent (Ohmeda 7900, Datex-Ohmeda, Madison, WI) to previous Ohmeda (7810 and 7000, Datex-Ohmeda, Madison, WI) anesthesia ventilators. To determine airway pressure and minute ventilation thresholds for intraoperative use of a critical care ventilator. ⋯ The improved pressure and flow capabilities of the SmartVent increase the threshold for using a critical care ventilator intraoperatively to a peak airway pressure > 65 cm H2O and/or VE > 18 L/min.
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Case Reports
An anteromedial internal jugular vein successfully cannulated using the assistance of ultrasonography.
The internal jugular vein usually is found either lateral or anterolateral to the carotid artery when it is cannulated for central vein access using external anatomical landmarks. We report a case in which the carotid artery was inadvertently punctured, but the right internal jugular vein could not be found. ⋯ A figure showing the ultrasound of this rare anatomical variation is provided. The advantages and utility of ultrasound when used for the placement of internal jugular central vein catheters are reviewed.