Journal of clinical anesthesia
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We report two patients with a history of dural puncture who developed paradoxical postural cerebrospinal fluid leak-induced headache. The patients' headache worsened when they were in the recumbent position, and it improved when they were placed upright. ⋯ The patients were successfully treated with autologous epidural blood patch. The mechanism for PPCLH is to be elucidated.
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To assess the efficacy of dexmedetomidine in providing sedation during electroencephalographic (EEG) analysis in children with autism, seizure disorders, or pervasive developmental disorders (PDDs). ⋯ Dexmedetomidine provides effective sedation during EEG analysis in children with autism or PDD.
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There is a high rate of relapse among anesthesia residents attempting to re-enter clinical anesthesia training programs after completing treatment for opioid addiction. Individuals may return to clinical practice after a short period of treatment only to relapse into active addiction, and for the opioid addicted anesthesia resident, this often results in death. The objective of this study was to determine weather or not a period of time away from clinical practice after treatment would reduce the rate of relapse by allowing the individual to concentrate on recovery in the critical first year after treatment, during which the majority of relapses occur. ⋯ The treatment of addicted physicians can be successful, and return of the highly motivated individual to the clinical practice of Anesthesiology is a realistic goal, but this reintroduction must be undertaken in a careful, stepwise fashion. A full understanding of the disease process, the potential for relapse, and the implications of too rapid a return to practice must be taken into careful consideration.