Journal of clinical anesthesia
-
Randomized Controlled Trial Comparative Study
Comparing vertical and coracoid approaches for infraclavicular block in orthopedic surgery of the forearm and hand.
To determine if there is a difference between the vertical and coracoid approaches to the infraclavicular block. ⋯ The coracoid approach is convenient to perform with extensive block, and is thus an appropriate alternative to the vertical approach in infraclavicular block.
-
Case Reports
An adult patient with Klippel-Feil syndrome presenting for repeat operation: a cautionary tale of the GlideScope.
The introduction of video laryngoscopes has increased the success of intubating the difficult airway. However, failures have been reported in the literature that are associated with certain patient characteristics. Klippel-Feil Syndrome is a condition that typically presents with decreased cervical spine motion, a characteristic that has been associated with GlideScope failure. After an uneventful first anesthetic, a case of a near impossible-to-intubate occurred in a patient with Klippel-Feil Syndrome.
-
Traditional hemodynamic monitors such as pulmonary artery and central venous catheters provide continuous data and secure intravenous access, but their diagnostic efficacy has been criticized. Dynamic arterial waveform monitoring is promising, but studies suggest it is reliable only within narrow ventilation and rhythm parameters. ⋯ Recent efficacy data, along with other important clinical findings, are reviewed with regard to invasive monitors. We caution against over-generalizing from existing studies, and provide guidance for clinicians wishing to target monitoring techniques for appropriate patients.
-
Case Reports
A potentially hazardous complication during central venous catheterization: lost guidewire retained in the patient.
Guidewires are routinely used in the Seldinger technique during central venous catheter placement. A case in which a guidewire was unsuspectingly released and retained in a patient during the catheterization of the internal jugular vein is presented. Physicians from multiple services subsequently failed to detect the retained guidewire on several chest radiographs; however, the guidewire was incidentally discovered after a computed tomographic scan was obtained.
-
To determine the incidence and contributing factors of complications for patients receiving regional ophthalmic anesthesia. ⋯ Peribulbar block complications were rare. In this series, experience of caregivers and axial and needle length were not contributing factors.