Journal of clinical anesthesia
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Clinical Trial
Pharmacokinetics of ropivacaine during extradural anesthesia for total hip replacement.
To determine plasma concentrations of ropivacaine during epidural anesthesia with ropivacaine 10 mg/mL in patients undergoing elective total hip replacement. ⋯ Ropivacaine 10 mg/mL proved to be suitable for epidural anesthesia for total hip replacement. The plasma concentrations after 120 to 200 mg of its epidural application were not associated with signs of local anesthetic toxicity in patients pretreated with benzodiazepines, even in one case of suspected inadvertent intravascular application.
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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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Comparative Study
Effects of epidural anesthesia on the cardiovascular response to a rapid increase in isoflurane concentration.
To compare circulatory variables to an abrupt increase in isoflurance concentration via mask in patients who received either upper thoracic or lumbar epidural anesthesia, or neither. ⋯ Epidural anesthesia can blunt circulatory responses to a sudden increase in isoflurane concentration.
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A case of advanced cryptogenic fibrosing alveolitis (CFA) with multiple bullae and extensive pulmonary fibrosis, scheduled for modified radical mastectomy for carcinoma of breast, is presented. This patient had ischemic heart disease, corticosteroid-induced hypertension, diabetes mellitus, and a difficult airway. Thoracic epidural segmental anesthesia was successfully given to this patient. Preoperative problems, perioperative management, and alternative anesthetic techniques are discussed.
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Case Reports
Cardiac arrest due to succinylcholine-induced hyperkalemia in a patient with wound botulism.
Cardiac arrest due to hyperkalemia is a known complication of succinylcholine administration in patients with neuromuscular disease, extensive burns, and prolonged immobility. We report a case of hyperkalemic cardiac arrest following the administration of succinylcholine in a patient suffering from wound botulism.