Journal of clinical anesthesia
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Review Case Reports
Intraoral vascular malformation and airway management: a case report and review of the literature.
A patient with a large airway venous malformation underwent anesthesia for a tooth extraction. The procedure was uneventful until extubation, immediately after which complete airway obstruction resulted. After unsuccessful attempts to relieve the problem, the patient's trachea was reintubated. ⋯ Anesthesiologists must be concerned with any airway vascular abnormality. Most abnormalities involving the airway are either hemangiomas or venous malformations. The anesthesiologist must diagnose the problem correctly because even minor manipulation of a venous malformation may result in exsanguination, or the malformation may become engorged and compromise the airway.
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Uterine inversion following vaginal delivery or during Cesarean section is rare. Cardiovascular instability resulting from blood loss is possible. This article describes the use of intravenous nitroglycerin as an alternative to the induction of general anesthesia and administration of volatile anesthetics to provide uterine relaxation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of the efficacy of esmolol and alfentanil to attenuate the hemodynamic responses to emergence and extubation.
To define the ability of esmolol and alfentanil to control the hemodynamic changes associated with extubation and emergence. ⋯ Emergence and extubation after inhalation general anesthesia result in significant increases in BP and HR in healthy patients. An esmolol bolus dose and subsequent infusion significantly attenuated these responses. A small bolus dose of alfentanil minimized the responses to emergence but prolonged the time to extubation and was no longer protective at that point.
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Randomized Controlled Trial Comparative Study Clinical Trial
Patient-controlled drug administration during local anesthesia: a comparison of midazolam, propofol, and alfentanil.
To evaluate the perioperative effects of alfentanil, midazolam, and propofol when administered using a patient-controlled analgesia (PCA) device during local anesthesia. ⋯ When self-administered as adjuvants during local anesthesia using a PCA delivery system, alfentanil, midazolam, and propofol were equally acceptable to patients. However, propofol and midazolam were associated with fewer perioperative complications than was alfentanil.