Journal of clinical anesthesia
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Case Reports
Cardiac arrest due to succinylcholine-induced hyperkalemia in a patient with wound botulism.
Cardiac arrest due to hyperkalemia is a known complication of succinylcholine administration in patients with neuromuscular disease, extensive burns, and prolonged immobility. We report a case of hyperkalemic cardiac arrest following the administration of succinylcholine in a patient suffering from wound botulism.
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To prospectively assess the impact of a liberalized preoperative fasting policy on operating room (OR) utilization. ⋯ Liberalizing a preoperative fasting policy and allowing patients to consume unrestricted clear fluids up until 3 hours before their scheduled time of surgery did not affect their compliance with fasting requirements. No increase in cancellations or delays of surgical procedures due to inappropriate oral intake was observed.
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Comparative Study
Comparison of acute normovolemic hemodilution and preoperative autologous blood donation in clinical practice.
To compare, by model simulation, acute normovolemic hemodilution (ANH) and preoperative autologous blood donation (PABD) to predict their efficacy in current clinical practice. To discuss their similarities and offer guidelines based on expected operative blood loss. ⋯ PABD exemplifies a "chronic" form of ANH in current clinical practice and offers little advantage over ANH as a blood conservation technique for high-blood-loss operations. When surgical blood loss is predictably mild to moderate (range 250 to 1,000 mL), neither blood conservation technique is necessary.
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Case Reports
Complex regional pain syndrome (CRPS) with resistance to local anesthetic block: a case report.
We present a case of complex regional pain syndrome (CRPS) Type 1 in a 12-year-old girl. The patient did not respond to the usual therapeutic modalities used to treat CRPS, including physical therapy, lumbar sympathetic block, epidural local anesthetic block, intravenous lidocaine infusion, or other oral medications. Of note is the fact that, during epidural block, the patient demonstrated a resistance to local anesthetic neural blockade in the area of the body involved with the pain problem. The mechanism of this resistance could be related to the changes in the dorsal horn cells of the spinal cord, secondary to activation of N-methyl-D-aspartate receptors, which may play a role in the pathophysiology of this pain syndrome.