Journal of clinical anesthesia
-
Lower limb orthopedic operations are frequently performed under regional anesthesia, which allows avoidance of potential side effects and complications of general anesthesia and sedation. Often though, patients feel anxious about being awake during operations. To decrease intraoperative anxiety, we use multimedia equipment consisting of a tablet device, noise-canceling headphones, and a makeshift frame, where patients can listen to music, watch movies, or occupy themselves in numerous ways. ⋯ The anesthetic technique received a very positive appraisal by both patients and encouraged us to study further the impact of modern audiovisual technology on anxiolysis for major surgery under regional anesthesia. The duration of surgery per se is not a contraindication to the use of audiovisual distraction. The absolute proviso of successful application of this technique to major surgery is effective regional anesthesia and good teamwork between the clinicians and the patients.
-
The study objective is to compare change in postoperative blood glucose from preoperative values in patients with type II diabetes mellitus receiving 4- or 8-10-mg dexamethasone for postoperative nausea and vomiting prophylaxis. ⋯ Dexamethasone 8-10 mg is associated with a significantly greater perioperative increase in blood glucose compared with a 4-mg dose.
-
Postdural puncture headache is a known complication after lumbar puncture. In elderly patients, postdural puncture headache necessitating epidural blood patch is considered rare. The literature assessing the use and safety of epidural blood patch in the elderly is sparse; therefore, in the present study, the use and efficacy of epidural blood patch in patients 65 years or older was evaluated. ⋯ The elderly may also develop postdural puncture headache, and epidural blood patch is an effective and well-tolerated treatment of persistent and severe symptoms.
-
The objective was to analyze the impact of a peripheral nerve block in addition to general anesthesia on hospital admission after surgical rotator cuff repair. ⋯ For patients undergoing surgical rotator cuff repair under general anesthesia, the addition of a peripheral nerve block may be associated with a reduction in the need for postoperative hospital admission after ambulatory surgery. Although the reason for this finding has to remain speculative, better pain control may play a role.