Journal of clinical anesthesia
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Case Reports
Bilateral continuous 3-in-1 nerve blockade for postoperative pain relief after bilateral femoral shaft surgery.
We tested the effectiveness of bilateral continuous paravascular femoral nerve blocks in a patient following bilateral femoral shaft surgery in whom other analgesic regimens were considered contraindicated or of limited effectiveness. Bilateral continuous femoral paravascular nerve blocks were performed using a previously described technique. General anesthesia was subsequently used to facilitate surgery, which was a bilateral osteosynthesis using dynamic hip screws for osteolytic metastases of the proximal extremities of both femurs. ⋯ Plasma concentrations of lidocaine were consistently below toxic levels (1.35 to 1.65 micrograms/ml). Radiographic contrast studies failed to demonstrate movement of contrast to the level of the lumbar plexus. Bilateral continuous femoral paravascular nerve blocks can be used to provide effective and safe analgesia in patients requiring aggressive analgesia in whom other techniques may be contraindicated.
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We present a case of intramural hematoma initially misdiagnosed as angina, and requiring myocardial revascularization. Angiography failed to lead to the proper diagnosis and the original transesophageal echocardiogram was misinterpreted as showing an intimal flap that was actually an echocardiographic artifact. The echocardiographic characteristics and implications of this entity are reviewed.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of three different doses of intrathecal fentanyl and sufentanil for labor analgesia.
To compare the duration of analgesia and incidence of side effects of three doses of intrathecal fentanyl (25 micrograms, 37.5 micrograms, 50 micrograms) with three doses of intrathecal sufentanil (5 micrograms, 10 micrograms, 15 micrograms). ⋯ Intrathecal sufentanil produced analgesia of longer duration than fentanyl for all doses studied. The duration of pruritus with sufentanil was also longer.
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Randomized Controlled Trial Comparative Study Clinical Trial
Prophylactic antiemetics for laparoscopic cholecystectomy: a comparison of perphenazine, droperidol plus ondansetron, and droperidol plus metoclopramide.
To compare the prophylactic administration of ondansetron plus droperidol, droperidol plus metoclopramide, and perphenazine to determine effects on postoperative nausea, vomiting, and sedation after laparoscopic cholecystectomy. ⋯ These three drug regimens are equivalent for antiemetic prophylaxis before laparoscopic cholecystectomy.
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Randomized Controlled Trial Clinical Trial
Oral clonidine premedication does not prolong analgesia after herniorrhaphy under subarachnoid anesthesia.
To determine the effect of oral clonidine premedication on duration of sensory and motor block, postoperative analgesia, hemodynamic stability, sedation, and respiratory parameters after subarachnoid anesthesia (SA). ⋯ In healthy patients, premedication with oral clonidine provided useful sedation and anxiolysis and stable hemodynamics, without prolongation of sensory and motor block. Side effects occurred only with clonidine 5 mcg/kg. Thus, a dose of 2.5 mcg/kg is recommended.