Journal of clinical anesthesia
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We report a case in which sufentanil was given to a patient who was already taking both a monoamine oxidase (MAO) inhibitor and a tricyclic antidepressant. Anecdotal reports have recommended discontinuing MAO inhibitors 2 to 3 weeks prior to elective surgery. ⋯ She was given an uneventful elective anesthetic with measures to minimize the risk of an adverse drug reaction involving the antidepressants she was taking. Our experience suggests that the use of an opioid other than meperidine may allow the anesthetist to proceed cautiously to provide an anesthetic for an elective surgery patient who is also currently receiving MAO inhibitor therapy.
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Randomized Controlled Trial Clinical Trial
The efficacy of routine central venous monitoring in major head and neck surgery: a retrospective review.
To further define the efficacy of routine central venous catheter placement for major head and neck surgery from the standpoint of fluid and blood administration, and various other parameters of perioperative management. ⋯ The study raises doubt about the efficacy of routine central venous catheter placement as a necessary guide for fluid and blood administration for these procedures, or as a necessary adjunct for several other parameters of perioperative management. It suggests the need for a randomized, prospective evaluation.
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T-cell lymphoma is the fastest growing non-Hodgkin's lymphoma occurring in children. Its clinical presentation is frequently abrupt, and total tumor mass can double every few days. ⋯ What information do we need, and how recent should it be? This case shows that recent diagnostic imaging studies not showing the presence of a mediastinal lymphoma can be misleading. It provides a strong warning to all anesthesiogists involved in ambulatory anesthesia.