Journal of clinical anesthesia
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Randomized Controlled Trial
A randomized, placebo-controlled study of pregabalin for postoperative pain intensity after laparoscopic cholecystectomy.
To determine the efficacy of two different doses (150 mg and 300 mg) of preoperative pregabalin on pain relief and total opioid consumption after laparoscopic cholecystectomy. ⋯ Preoperative pregabalin may be a useful analgesic for patients after laparoscopic cholecystectomy, as it lowers pain intensity and opiod consumption, and does not increase the frequency of side effects.
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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.
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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.
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A 57 year old woman with no previous history of any sensory deficits developed anosmia and hypogeusia after general anesthesia for laparoscopic cholecystectomy, with complete recovery over 6 months. There were no other identifiable factors that may have contributed to her anosmia and hypogeusia after general anesthesia. As anosmia and hypogeusia related to anesthesia and surgery are not frequently reported, the incidence of these events related to anesthesia may be higher than expected.
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To investigate whether the phase of menstrual cycle influences the incidence of postoperative nausea and vomiting (PONV) in women undergoing general anesthesia for elective laparoscopic gynecological surgery. ⋯ Patients in the luteal phase of their menstrual cycle may have a decreased risk of PONV after laparoscopic gynecological surgery in the early postoperative period.