Journal of clinical anesthesia
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To evaluate intraperitoneal ropivacaine delivery with the AeroSurge device in the clinical setting and to evaluate the total systemic ropivacaine levels achieved following delivery of 50 mg of aerosolized ropivacaine. ⋯ This preliminary study confirms that aerosolized intraperitoneal local anesthetic is feasible, with ropivacaine concentrations remaining within safe levels.
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Evidence supports the concept that patients undergoing major orthopedic surgery benefit from either thromboprophylaxis or peripheral nerve blocks, especially continuous techniques. A group of anesthesiologists with significant experience in orthopedic anesthesia and peripheral nerve blocks reviewed the literature related to thromboprophylaxis and peripheral nerve blocks and their combination in orthopedics. Major bleeding, including retroperitoneal hematoma, is an established complication of thromboprophylaxis. ⋯ Between 1997 and 2012, only 4 case reports of major bleeding were reported in patients receiving thromboprophylaxis and peripheral nerve blocks. Evidence supports the safety of the combination of thromboprophylaxis and peripheral nerve blocks. This group of experts concluded that currently there is no evidence that the combination of thromboprophylaxis and peripheral nerve block increases the risk of major bleeding compared to either of the treatments alone.
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To determine whether postoperative epidural analgesia is associated with better recurrence-free survival and overall survival after lung cancer surgery. ⋯ The type of postoperative analgesia used after surgery for nonsmall cell lung cancer is not associated with better 2-year or 5-year recurrence-free survival or overall survival rates.
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A case of tension pneumopericardium that occurred after total gastrectomy in an 80 year old woman is presented. There have been some prior case reports of pneumopericardium that occurred during positive pressure ventilation; in this patient hypotension due to tension pneumopericardium occurred after extubation. Return of spontaneous ventilation with negative-pressure breathing may have induced air aspiration into the pericardial sac from the abdominal cavity.
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To determine, for two different age groups, the effect of duration of sevoflurane administration on the amount of propofol needed when performing tracheal intubation. ⋯ The amount of propofol needed to supplement sevoflurane in children 1-6 years of age can be expected to decrease after 4 minutes of sevoflurane.