Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study
A randomized trial examining preoperative sedative medication and postoperative sleep in children.
Midazolam has been found to have beneficial effects on anxiety in children in the preoperative setting. Prior studies have examined various postoperative behaviors of children, but little research has examined the effects of preoperative use of midazolam with postoperative sleep. The purpose of this investigation was to compare postoperative sleep in children as a function of preoperative sedative medication use. ⋯ Children who received midazolam before surgery had similar postoperative sleep changes compared to children who did not receive midazolam. Further understanding of the postoperative behavioral effects of midazolam on children will help guide healthcare providers in their practice.
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Case Reports
Increased airway pressure due to superior mediastinal hematoma during endovascular coiling by transcarotid approach.
An elderly woman with subarachanoid hemorrhage presented to our interventional neuroradiology suite for coil embolization of multiple intracranial aneurysms. The patient had difficult vascular access for the passage of microcatheter; hence, the embolization procedure was carried out with direct puncture of the left common carotid artery. ⋯ At the end of procedure, she developed airway compromise due to extension of a local neck hematoma into the superior mediastinum. The management issues in such a scenario have been discussed.
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Health care service bundling experiments at the state and regional levels have showed reduced costs by providing a single lump-sum reimbursement for anesthesia services, surgery, and postoperative care. Potential for cost savings related to the provision of anesthesia care has the potential to significantly impact sustainability. This study defines and quantifies routine and preventable anesthetic drug waste and the patient, procedure, and anesthesia provider characteristics associated with increased waste. ⋯ Significant potential savings with little impact on clinically significant availability may be achieved through the use of prefilled syringes for some commonly used anesthetic drugs. An intelligently implemented switch to prefilled syringes for select drugs is a potential cost saving measure, but savings might be diminished by disposal of prefilled syringes when they expire, hidden costs in the hospital pharmacy, and inability to supply some medications in prefilled syringes due to stability or manufacturing issues.
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Letter Case Reports
A patient with Churg-Strauss syndrome complicated with pulmonary hemoptysis.