Journal of clinical anesthesia
-
Randomized Controlled Trial Clinical Trial
The effects of thiopental sodium on fentanyl-induced muscle rigidity in a human model.
To describe a safe human model in which to study the treatment of fentanyl-induced muscle rigidity and report on the efficacy of thiopental sodium for this purpose. ⋯ Thiopental sodium does blunt the degree of muscle rigidity induced by high-dose fentanyl, though not as effectively as does succinylcholine. One can safely isolate an extremity prior to the administration of high-dose fentanyl and a muscle relaxant, intubate the trachea, and ventilate a patient, while retaining the ability to study the effect of centrally acting drugs on fentanyl-induced rigidity in the isolated extremity.
-
Case Reports
Epidural anesthesia for a cesarean section in a patient with pulmonary atresia and ventricular septal defect.
The perioperative management and the pathophysiology of a parturient with pulmonary atresia, ventricular septal defect, patent ductus arteriosus Botalli (PDA), and pulmonary hypertension are described. The patient previously had a cesarean section under general anesthesia and was currently managed with an epidural block. The outcome was successful for the mother. The postoperative period of the premature infant was characterized by hyaline membrane disease, with its typical sequelae.
-
To determine whether the anesthetic cardiac arrest rate decreased following the introduction of enhanced respiratory monitoring and increased safety awareness during the past decade. ⋯ The results support the hypothesis that improved respiratory monitoring was effective in decreasing anesthetic morbidity.
-
Case Reports
Total airway obstruction with neck extension: airway management of a patient with pharyngeal tumor.
Airway obstruction with the induction of anesthesia in children is common. Normally, neck extension with jaw thrust improves the airway. Flexion typically completes the obstruction. ⋯ We present a case of complete airway obstruction with neck extension in the presence of a nasopharyngeal tumor. Flexion rather than extension of the neck relieved this airway obstruction. We highly recommend radiologic studies with neck extension and flexion in such cases.
-
Case Reports
Application of the Mizus endotracheal obturator in tracheostomy and tentative extubation.
A variety of catheters, stylets, and obturators have been used to assist with problems in airway management. Obturators specifically designed for airway use are now available in different sizes. ⋯ Use of these obturators to preserve a path to the airway is described in cases of tracheostomy and tentative extubation. The advantages and disadvantages inherent in the use of such obturators are described.