Journal of clinical anesthesia
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Neural blockade of the scalp may be used as an adjunct to general anesthesia or serve as the principal anesthetic for both intracranial and extracranial procedures. Effective scalp blockade typically requires anesthetizing multiple peripheral nerves; blockade of one or more of these is often used to diagnose and treat conditions such as chronic headache. ⋯ The vascularity of the scalp, proximity of arteries supplying the cerebral circulation, use of large volumes of local anesthetic, and presence of intracranial devices or bony defects require attention. The impact of perioperative scalp blockade on acute and chronic pain may offer insight into the benefits of perioperative neural blockade generally.
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Randomized Controlled Trial
Preliminary evaluation of a virtual reality-based simulator for learning spinal anesthesia.
To evaluate the influence of a simulation-based program on the initial performance of dural puncture by medical interns, and to refine the design of simulator-based teaching and competence assessment. ⋯ Overall, no difference was measured between those taught with traditional methods and those, by a simulator based program in regard to the performance of spinal anesthesia.
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Case Reports
Anesthesia in a 12 year old boy with somatic overgrowth secondary to pericentric inversion of chromosome 12.
The management of a splenectomy in a boy with an unusual form of somatic overgrowth is presented. Except for a moderately difficult airway, no unusual reactions to anesthesia and surgery were encountered. Possible anesthetic implications of different somatic overgrowth syndromes in children are presented.
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The management of cesarean delivery for a parturient with placenta previa at 36 weeks' gestation and glutaric aciduria type 1 is presented. The management goal was to prevent encephalopathic crisis by ensuring adequate caloric intake with dextrose infusion and to provide carnitine supplementation and adequate anesthesia.