Journal of clinical anesthesia
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Oxygen-carrying hemoglobin (Hb) solutions are under intense investigation as an alternative to allogeneic red cell transfusion during surgery, with or without acute normovolemic hemodilution. We present a case in which an investigational Hb solution was used as an adjunct to acute normovolemic hemodilution, and as a replacement for surgical blood loss in a patient undergoing complex aortic reconstruction with a large blood loss.
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Randomized Controlled Trial Clinical Trial
Interleukin balance and early recovery from anesthesia in elderly surgical patients exposed to beta-adrenergic antagonism.
To determine whether proinflammatory and antiinflammatory cytokines, as measured in blood specimens, would correlate with improved SF-36 physical composite scores observed in elderly surgical patients who were administered perioperative atenolol. ⋯ Perioperative administration of atenolol to elderly surgical patients markedly improves physical sense of well-being, which coincides with improved postoperative pain control and decreased analgesic requirements. This improvement experienced by patients receiving atenolol is not related to alterations in perioperative cytokine response.
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Moving the last case of the day from one operating room (OR) to another OR can increase OR efficiency. However, there is a penalty cost for moving a case. The goal of the study was to measure perceptions of the minimum time that needs to be saved for it to be worthwhile to move a case from a late-running OR to another OR. ⋯ Members of the AACD perceive the penalty cost for moving a case to be 1 hour.
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Case Reports
Horner's syndrome following very low concentration bupivacaine infusion for labor epidural analgesia.
Horner's syndrome is a complication of epidural analgesia and anesthesia, encountered more commonly in pregnant women than in other patients. Previous reports described the appearance of Horner's syndrome following epidural injection of concentrated local anesthetic solutions. We report unilateral Horner's syndrome occurring in the setting of lumbar epidural analgesia for labor with a very low local anesthetic concentration (bupivacaine 0.04%) in an epidural infusion. We discuss the possible factors that could have contributed to this occurrence despite the extremely dilute concentration of local anesthetic used for analgesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Local anesthesia and midazolam versus spinal anesthesia in ambulatory pilonidal surgery.
To evaluate two anesthetic techniques, namely, local anesthesia with sedation, and spinal anesthesia, with respect to recovery times, postoperative side effects, pain scores, patient satisfaction, and hospital costs for ambulatory pilonidal disease surgery. ⋯ The use of local anesthesia-sedation for ambulatory anorectal surgery resulted in a shorter hospital time, lower hospital costs, and no side effects compared with spinal anesthesia.