Journal of clinical anesthesia
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To evaluate the consequences of opioid use for postoperative pain management and the degree to which these consequences may be reduced or minimized with opioid-sparing or opioid-replacement techniques. ⋯ Opioids will likely remain an integral part of postoperative pain management, but side effects increase the costs of care. The challenge is to identify situations where opioid-sparing techniques improve surrogate economic measurements and decrease overall hospital costs.
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Comparative Study
A comparison of Internet usage between two residency programs in the United Kingdom and the United States.
To survey the pattern of use and availability of the Internet among anesthesia residents. ⋯ If the reported survey results are representative of Internet use among anesthesia residents in the United States and UK, Internet access at work is associated with greater Internet use for medical purposes, perhaps in part because residents perceive it to be a convenient and accurate resource.
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Spontaneous rupture of the uterus is a life-threatening obstetrical emergency. Diagnosis may be delayed because of the bizarre presentation or absence of significant pain and tenderness, which could have been masked by the analgesic medications used during labor. We present a case of spontaneous rupture in a multigravid female who was undergoing oxytocin-augmented labor while receiving epidural analgesia. ⋯ At emergent cesarean section, a uterine rupture was noted. The uterine rupture extended down to the left vaginal angle, was not reparable and a hysterectomy was performed. The fetus survived.
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To determine the rate of unanticipated admissions and readmissions, and to characterize the associated reasons and costs. ⋯ At our teaching institution, approximately 1.5% of patients undergoing outpatient ambulatory surgery return within 30 days due to problems directly related to the original surgical procedure. Pain accounted for more than one third of return visits, incurring significant costs. Efforts to manage pain should focus not only on pain in the hospital but also anticipation of pain-related issues on discharge.