Journal of clinical anesthesia
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Dilution is often required to obtain appropriate concentrations of intrathecal morphine for analgesia. We compared techniques of diluting by measuring the quantity of morphine actually obtained in the final solution. ⋯ There is significant variability in the concentration of morphine actually contained in final solutions after dilution. Morphine presented in different premixed concentrations increases the risk of error. We advocate technique 5 as described above, whereas technique 1 should be prohibited.
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Accidental dural puncture (ADP) is known as a complication of epidural anesthesia. Although puncture site and advanced age have been reported to increase the risk of ADP, all related factors have not been fully investigated. We retrospectively investigated factors related to ADP in patients undergoing surgery. ⋯ Accidental dural puncture occurred in 0.49% of all surgical patients undergoing epidural anesthesia and was significantly related to those who received a puncture in lower thoracic and lumbar intervertebral spaces, whereas age was also an independent factor.
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The study objective is to determine the incidence of oral soft tissue trauma during classic direct laryngoscopy for tracheal intubation and the risk factors associated with it. ⋯ Our study reveals a high incidence of lesions grade 1 or 2 in soft tissue.
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Case Reports
Laparoscopic appendectomy in a pediatric patient with type 1 Charcot-Marie-Tooth disease.
A pediatric patient with type 1 Charcot-Marie-Tooth disease-a disorder associated with a demyelinating polyneuropathy-presented for laparoscopic appendectomy in the setting of acute appendicitis. Induction and maintenance of anesthesia were successfully managed without the use of any depolarizing or nondepolarizing neuromuscular blocking agents. The patient was successfully extubated at the completion of the procedure without any respiratory or neuromuscular sequelae, with excellent pain control and no postoperative nausea or vomiting.