Journal of clinical anesthesia
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Two cases of vocal cord closure, which was responsible for acute intraoperative impairment of mechanical ventilation in two patients with entropy-controlled depth of anesthesia, are reported. Administration of low-dose neuromuscular blocking drug was associated with immediate vocal cord relaxation and restoration of efficient mechanical ventilation.
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Lumbar chemical sympathectomy has been performed using fluoroscopic guidance for needle positioning. An 84 year old woman with atherosclerosis obliterans was referred to the pain clinic for intractable cold allodynia of her right foot. A thermogram showed decreased temperature of both feet compared with temperatures above both ankles. ⋯ Her blood pressure was 80/50 mmHg, and flank tenderness was noted. Retroperitoneal hemorrhage from the second right lumbar segmental artery was shown on computed tomography and angiography. Vital signs were stabilized immediately after embolization into the right lumbar segmental artery.
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Review Meta Analysis
Postoperative complications in patients with obstructive sleep apnea: a meta-analysis.
To determine whether a diagnosis of obstructive sleep apnea (OSA) imparts an increased risk of postoperative respiratory failure, cardiac events, and intensive care unit (ICU) transfer than patients with no OSA diagnosis. ⋯ Surgical patients with OSA are at increased risk of postoperative respiratory failure, cardiac events, and ICU transfer.
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Randomized Controlled Trial Comparative Study
The effects of propofol-midazolam-ketamine co-induction on hemodynamic changes and catecholamine response.
To compare the clinical efficacy of co-induction with propofol-midazolam-ketamine with etomidate as the sole induction agent. ⋯ The higher norepinephrine/epinephrine ratio noted in the single-drug group may be implicated in lower adrenal sympathetic activity. Propofol-midazolam-ketamine co-induction may be used instead of etomidate for anesthesia induction in patients with hemodynamic instability.
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To study changes in BIS values and metabolic parameters during an infusion of isoproterenol in pediatric patients. ⋯ Isoproterenol increases metabolic, respiratory, and BIS values in pediatric patients during general anesthesia. We recommend the use of BIS, close monitoring of ETCO2, and careful titration of anesthetics during isoproterenol infusion, especially when lighter planes of general anesthesia are requested for pediatric electrophysiologic procedures.