Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study
A comparison of ultrasound alone vs ultrasound with nerve stimulation guidance for continuous femoral nerve block in patients undergoing total knee arthroplasty.
To compare analgesic efficacy of ultrasound (US) guidance alone and US guidance combined with nerve stimulation (NS) for continuous femoral nerve block (CFNB) in patients undergoing total knee arthroplasty (TKA). ⋯ US-guided CFNB was associated with similar analgesic efficacy and block failure rate and reduced procedure time compared to US with NS guidance for CFNB in patients undergoing TKA.
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Review Meta Analysis Comparative Study
Incidence of postoperative shivering comparing remifentanil with other opioids: a meta-analysis.
To determine whether the administration of remifentanil increases the incidence of postoperative shivering in comparison with the administration of alfentanil, fentanyl, or sufentanil. ⋯ Our meta-analysis showed that remifentanil was associated with an increased incidence of postoperative shivering compared with alfentanil or fentanyl, but no significant difference was seen when compared with sufentanil.
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We report the case of a 17-month-old child who underwent laparotomy under general anesthesia and caudal block. Electrocardiogram ST-T changes were observed after local anesthetic injection. ⋯ Thereby, we conduct a brief review of the subject in pediatrics. As a major conclusion, we strongly recommend the "fast-track" lipid rescue as soon as this severe complication is detected.
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We investigated the prevalence of lifestyle risk factors in patients admitted to our preoperative assessment outpatient clinic, and compared patient self-reports and anesthetist reports of health risk factors to evaluate the patient self-image of preoperative health status. ⋯ The prevalence of lifestyle risk factors in perioperative patients is high, and differences in reporting between patients and anesthetists may suggest that patients are unaware of or ignore their unhealthy state. Further studies are warranted to investigate the association between the lifestyle risk factors and outcome in the anesthesiology setting.
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We report the use of rotational thromboelastometry (ROTEM) to guide the management of a 29-year-old primigravida at 36weeks' gestation with portal hypertension, esophageal varices, suspected pseudocholinesterase deficiency, and steroid refractory thrombocytopenia presenting to labor and delivery with worsening peripheral edema and new-onset hypertension. A multidisciplinary decision for preoperative platelet transfusion and cesarean delivery under spinal anesthesia was made, guided by ROTEM. A successful cesarean delivery was performed with no bleeding complications.