Journal of clinical anesthesia
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Observational Study
Cardiac and hemodynamic consequences during capnoperitoneum and steep Trendelenburg positioning: lessons learned from robot-assisted laparoscopic prostatectomy.
To determine and interpret the changes in preload, afterload, and cardiac function in the different phases of robot-assisted laparoscopic prostatectomy. ⋯ Selective arterial vasodilation at the time of capnoperitoneum may normalize afterload and myocardial oxygen demand.
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Meta Analysis Comparative Study
Intra-articular lidocaine versus intravenous analgesia and sedation for manual closed reduction of acute anterior shoulder dislocation: an updated meta-analysis.
To compare intra-articular lidocaine (IAL) with intravenous analgesia and sedation (IVAS) for manual closed reduction of acute anterior shoulder dislocation. ⋯ Intra-articular lidocaine injection may be safer than IVAS because there are fewer risks of postoperative complications with IAL. Both techniques are similarly effective for manual closed reduction of acute anterior shoulder dislocation.
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Randomized Controlled Trial
Which nostril should be used for nasotracheal intubation: the right or left? A randomized clinical trial.
To determine which nostril is more suitable for nasotracheal intubation in patients with normal patency of both nostrils. ⋯ Nasal intubation via the right nostril is more safely performed than with the left nostril. Because of less epistaxis and faster intubation.
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To determine if a high score (≥ 3) on the STOP-Bang screening questionnaire for obstructive sleep apnea (OSA) predicts whether obese patients are at high risk for OSA and increased risk of difficult airway. ⋯ The STOP-Bang score may be used as an effective predictor of difficult airway in obese patients. Obese surgical patients with unknown/undiagnosed OSA status should be evaluated using the STOP-Bang questionnaire score.
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We report an incident of delayed onset of true vocal fold paralysis with continuous interscalene brachial plexus block. A 51 year old woman underwent left shoulder manipulation and lysis of adhesions with fluoroscopy and general anesthesia. ⋯ The patient was admitted for observation and the catheter was discontinued with no intubation required. By the next morning, the patient's dysphagia and dyspnea had resolved and her hoarseness improved.