Journal of clinical anesthesia
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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.
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Comparative Study Clinical Trial
Vascular endothelial growth factor (VEGF) in plasma increases after hip surgery.
To determine whether the plasma concentration of vascular endothelial growth factor (VEGF) is elevated after a common surgical procedure, and if any increase is followed by a reduction in the amount of infused crystalloid fluid in the blood. ⋯ Intravascular persistence of infused crystalloid is increased after hip surgery despite elevated VEGF levels in plasma.
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Case Reports
Folding of the epiglottis - an unusual complication to be recognized after laryngoscopic endotracheal intubation.
We report a case of folding of the epiglottis during endotracheal intubation, an unusual complication of intubation. A 36-year-old female patient underwent laryngeal microsurgery for a vocal polyp. Following anesthesia induction, an endotracheal tube (ID = 6.0 mm, cuffed) was advanced through an intubating laryngoscope via the oropharyngeal route. ⋯ There were no sequelae such as laryngeal spasm or vocal cord palsy after the surgery. The "peardrop" phenomenon is suggested as a possible cause of this event. Potential adverse outcomes of this unusual occurrence are reviewed.
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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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Comparative Study
Establishing a nurse-based, anesthesiologist-supervised inpatient acute pain service: experience of 4,617 patients.
To describe our nurse-based Acute Pain Services (APS) and present the results of 4617 patients treated by our service. ⋯ A nurse-based APS provides effective and safe postoperative pain management.