Journal of clinical anesthesia
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Case Reports
Hyperosmolar, increased-anion-gap metabolic acidosis and hyperglycemia after etomidate infusion.
Hyperosmolar increased-anion-gap metabolic acidosis without hyperglycemia has been reported after infusions of etomidate and other medications containing propylene glycol. We report a case of this biochemical abnormality with severe hyperglycemia. Cessation of the etomidate infusion along with other supportive measures resulted in prompt resolution of the metabolic acidosis and hyperglycemia.
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To determine the safety and efficacy of regional anesthesia techniques when administered in the office-based setting. ⋯ On the basis of our experience, we believe that regional anesthesia can be delivered efficiently and safely for orthopedic procedures in the office-based environment, and we encourage its wider use.
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To examine the efficacy of recombinant factor VIIa (rVIIa) in reversing warfarin-induced coagulopathy in trauma patients presenting with intracranial hemorrhage (ICH). ⋯ Factor rVIIa provides prompt correction of the INR of dose-dependent duration in patients with ICH intracranial hemorrhage associated with warfarin use.
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Randomized Controlled Trial Comparative Study
Postoperative analgesia after total hip arthroplasty: patient-controlled analgesia versus transdermal fentanyl patch.
To determine whether a new transdermal fentanyl patch (TFP) is a good choice for the postoperative pain management of patients undergoing primary total hip arthroplasty compared with patient-controlled analgesia (PCA). ⋯ Preoperative TFP application decreases pain scores and morphine consumption in the PACU and appears to have prolonged effects spanning the first 48 postoperative hours.