Journal of clinical anesthesia
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Fever is a common clinical problem in labor and delivery suites. It can result from a variety of infectious microorganisms, tissue trauma, malignancy, drug administration, and endocrine and immunologic disorders. ⋯ The diagnosis of infection in pregnancy often raises questions about the safety of regional anesthesia in febrile patients. Despite this concern, and lack of universal guidelines, it has now been well established that the presence of infection and fever in labor does not always contraindicate the administration of regional anesthesia.
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Many anesthesiologists have called for the abandonment of the epidural test dose in the obstetric patient, citing its lack of sensitivity and specificity. A test dose of lidocaine 1.5% with epinephrine 1:200,000, in combination with aspiration, is highly effective in detecting incorrect placement of an epidural catheter. ⋯ It should not be administered during uterine contraction, as labor pain may trigger a tachycardic response. This test dose has been extensively studied and is safe both for both mother and fetus.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of general and spinal anesthesia and their influence on hemostatic markers in patients undergoing total hip arthroplasty.
To evaluate the profile of molecular hemostatic markers in patients receiving either spinal or balanced general anesthesia for total hip arthroplasty. ⋯ Our initial hypothesis that the lesser risk of postoperative DVT in patients undergoing total hip arthroplasty in regional anesthesia is reflected in the course of the plasmatic molecular markers of hemostasis could not be verified. There were no significant differences in the timely course of the markers at any given time point.
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Comparative Study
Evaluation of intense neuromuscular blockade caused by rocuronium using posttetanic count in male and female patients.
To establish the relationship between train-of-four (TOF) nerve stimulation and the number of posttetanic twitches (posttetanic count [PTC]) during neuromuscular blockade caused by rocuronium in males and females. ⋯ Even though the times from initial administration of rocuronium 1 mg.kg(-1) to the first appearances of T3 and T4 are significantly longer in female patients, the intervals to the first detectable responses to PTTS and TOF are not significantly different between females and males. Gender has no significant effect on the relation between PTC and the time to T1.