Journal of clinical anesthesia
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We describe a case of a failed implanted, programmable, intrathecal infusion pump-and its external programmer-leading to morphine withdrawal symptoms, in a patient with failed back syndrome.
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We report on a new optic laryngoscope blade that provides two views of the larynx during tracheal intubation. The availability of an alternative direct view of the larynx may improve the ability of anesthesia providers to observe the tracheal tube passing through the vocal cords when using a Macintosh laryngoscope blade. The optic port improved visualization of passage of the endotracheal tube in obese patients. However, further studies are needed in patients with difficult airways to determine whether this new blade will ease the ability of practitioners to insert a tracheal tube.
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The acquisition and maintenance of essential psychomotor skills that are only required sporadically is a significant problem in medical training and practice. It is of particular relevance to anesthesiologists with regard to fiberoptic intubation, a technique that may be under-utilized despite its central role in the management of the difficult airway. ⋯ We describe an educational resource (Dexter), which has been developed to overcome these problems. Dexter is a nonanatomical, endoscopic dexterity training system designed to encourage practice and help establish and maintain a state of procedural readiness, even if clinical exposure to difficult airway situations is sporadic.
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To describe our initial experience of the perioperative anesthetic care provided to pediatric recipients during living-related liver transplantation. ⋯ Total IV anesthesia with fentanyl, midazolam, and cisatracurium, after preoperative optimization, is a well-tolerated approach for children undergoing living-related liver transplantation and offers quick recovery. This anesthetic technique was aimed at minimizing the effects on the cardiovascular system, and also any consequences related to the possible occurrence of a reperfusion syndrome. Fluid balance was aimed at optimizing flow through the hepatic graft and preventing thrombosis of vascular anastomoses.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Comparison of ropivacaine-fentanyl patient-controlled epidural analgesia with morphine intravenous patient-controlled analgesia for perioperative analgesia and recovery after open colon surgery.
To compare the effects of ropivacaine-fentanyl patient-controlled epidural analgesia (PCEA) with morphine intravenous (IV) patient-controlled analgesia (PCA). ⋯ Ropivacaine-fentanyl PCEA provides superior analgesia, reduced opioid requirement, and more rapid recovery after colon surgery.