Journal of clinical anesthesia
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Randomized Controlled Trial Clinical Trial
Antagonism of profound cisatracurium and rocuronium block: the role of objective assessment of neuromuscular function.
The purpose of this study is to determine the incidence of significant (train-of-four [TOF] ratio <0.70), but clinically undetectable (TOF ratio >0.40), residual neuromuscular block after neostigmine antagonism of profound cisatracurium (CIS) or rocuronium (ROC) block. ⋯ Most clinicians cannot detect tactile fade once the TOF ratio exceeds 0.40. When reversing profound block, an objective monitor of neuromuscular function is required if the extent of residual block is to be assessed with any confidence.
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Randomized Controlled Trial Clinical Trial
Oral multidose caffeine-paracetamol combination is not effective for the prophylaxis of postdural puncture headache.
To investigate the effects of different doses of oral caffeine-paracetamol combinations in postdural puncture headache (PDPH) prophylaxis. ⋯ Prophylactic administration of paracetamol-caffeine combinations at the stated doses does not prevent PDPH.
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Randomized Controlled Trial Clinical Trial
Effects of atrial natriuretic peptide at a low dose on water and electrolyte metabolism during general anesthesia.
To assess the hemodynamic, renal, and endocrine effects of small continuous doses of atrial natriuretic peptide (ANP) in patients anesthetized with sevoflurane for gastrectomy. ⋯ Continuous intravenous infusion of ANP at 0.05 microg/kg/min during gastrectomy was associated with greater water and electrolyte excretion unaccompanied by changes in potentially interacting hormones. Low-dose infusion may be particularly safe and useful for controlling water and electrolyte metabolism intraoperatively.
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To determine the postoperative outcome of narcolepsy patients, a population that may be at increased risk of perioperative complications, including postoperative hypersomnia, prolonged emergence after general anesthesia, and apnea. ⋯ Pharmacological therapy for narcolepsy should be continued during the perioperative period. In addition, treated narcolepsy patients are at no increased risk for postoperative complications.
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A 35-year-old, 39-week pregnant woman underwent an uneventful emergent cesarean delivery for suspected placental abruption or uterine dehiscence. Given the urgency of the situation and the unremarkable airway anatomy, general anesthesia was the chosen technique. ⋯ Hematology tests performed before the cesarean delivery revealed severe thrombocytopenia. This was later diagnosed as idiopathic thrombocytopenia, which was treated successfully with steroid therapy.