Journal of clinical anesthesia
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Management of the difficult airway is an essential skill that should be taught during an anesthesiology residency. However, only a minority of anesthesiology residency programs have formal rotations in advanced airway management. ⋯ We believe that this rotation has been beneficial in improving the residents' exposure to advanced airway techniques, and has dramatically improved their capabilities in this important aspect of anesthetic of anesthetic training. Additionally, the structure of the rotation ensures uniformity in the residents' acquisition of advanced airway skills.
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We report an 11-year-old male with undiagnosed myopathy, who developed cardiac arrest secondary to severe rhabdomyolysis and hyperkalemia following succinylcholine administration. The patient required extracorporeal membrane oxygenation support from which he was eventually weaned successfully. He died eleven days after the cardiac arrest as a result of apparent ischemic brain injury.
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A severe limb injury challenges an anesthesiologist's ability to provide care. We describe the difficulties encountered by an anesthesiology resident with a severely injured left arm and present solutions to overcoming an inability to perform traditional direct laryngoscopy. Airway management adjuncts explored include modified left-handed direct laryngoscopy, lighted stylet intubation, fiberoptic intubation, Laryngeal Mask Airway, Combitube, retrograde wire technique, and the eventual conversion to direct laryngoscopy with the right hand with the reversed Macintosh and the Cranwall modification of the Miller blade. The practical and social problems of a disability during residency are also discussed.
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To study labor outcomes in parturients receiving oxytocin for augmentation or induction of labor, in the presence of labor epidural analgesia. ⋯ Patients who have their labor induced request analgesia sooner and are at a higher risk of cesarean section than are patients who go into labor spontaneously. Any study that purports to assess the effects of epidural analgesia in labor should distinguish between induced and augmented/spontaneous labor.
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Randomized Controlled Trial Comparative Study Clinical Trial
The postoperative analgesic efficacy of wound instillation with ropivacaine 0.1% versus ropivacaine 0.2%.
To assess the influence of ropivacaine concentration on wound instillation-induced postoperative analgesia following total abdominal hysterectomy with bilateral salpingo-oophorectomy. ⋯ With a pre-set volume, varying the concentration of ropivacaine (0.1% versus 0.2%) does not affect the analgesic efficacy of wound instillation following total abdominal hysterectomy with bilateral salpingo-oophorectomy.