Journal of clinical anesthesia
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Randomized Controlled Trial
The suppressive effects of landiolol administration on the occurrence of postoperative atrial fibrillation and tachycardia, and plasma IL-6 elevation in patients undergoing esophageal surgery: A randomized controlled clinical trial.
To determine whether perioperative landiolol administration suppresses postoperative atrial fibrillation (AF) and the plasma cytokines elevation in patients undergoing esophageal cancer surgery. ⋯ Perioperative landiolol administration suppressed the incidence of new-onset of AF as well as sinus tachycardia, and the plasma IL-6 elevation in patients undergoing esophageal cancer surgery.
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Comparative Study
Can we reduce anesthesia exposure? Neonatal brain MRI: Swaddling vs. sedation, a national survey.
Neonatal magnetic resonance imaging (MRI) is a diagnostic modality that requires minimal motion to acquire quality images. Sedation or even general anesthesia may be necessary to achieve acceptable scans. There is a growing body of literature, especially in animal studies, that links neurotoxicity with anesthetic exposure to the developing brain. There is no study outlining strategies used by neonatal intensive care units (NICU) to achieve quality MRI images with limited exposure to medications identified as possibly harmful to the developing brain. ⋯ The majority of NICUs in the US that responded to the survey utilized feed and swaddle as their primary technique for obtaining MRIs of the brain and reported a high success rate. Given the growing concern over the possible neurotoxic effects of anesthetic drugs on the developing brain, more centers should consider this technique as a first line method to obtain brain MRIs, with sedation and GA reserved for failed feed and swaddle attempts and special circumstances.
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We report a case of paradoxical presentation of a postural postdural puncture headache secondary to dural puncture with a 25-gauge Whitacre needle for combined spinal-epidural anesthesia. This 27-year-old female patient presented to the emergency department with elevated blood pressure and a global headache 9 days after administration of epidural anesthesia for a spontaneous vaginal delivery after an uncomplicated pregnancy. The patient reported that the headache was more intense when lying down and immediately improved when she sat or stood up from a recumbent position. The patient was discharged from emergency department after an improvement following treatment with labetalol, ondansetron, ketorolac, and fluid resuscitation.
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Comparative Study
Pharmacokinetics and pharmacodynamics of cisatracurium in patients undergoing surgery with two hemodilution methods.
To investigate the pharmacokinetics and pharmacodynamics of cisatracurium in patients undergoing surgery under acute normovolemic hemodilution (ANH) and acute hypervolemic hemodilution (AHH). ⋯ When using cisatracurium under AHH, the dosage should be increased appropriately, while it need not be adjusted under ANH.