Journal of clinical anesthesia
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Propofol was used for the induction and maintenance of anesthesia in a patient undergoing a laparoscopic tubal ligation. This new anesthetic has not been associated with postoperative ventricular arrhythmias. This report demonstrates the occurrence of supraventricular tachycardia deteriorating to ventricular tachycardia in a patient who received propofol. Included is a discussion of the possible causes of this event.
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Comparative Study
Secondary polycythemia does not increase the risk of perioperative hemorrhagic or thrombotic complications.
To determine the effects of secondary polycythemia on perioperative hemorrhagic and thrombotic complications. ⋯ Secondary polycythemia does not impart any added perioperative risk.
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This report describes the case of an 80-year-old woman with a long history of chronic, stable angina pectoris who underwent resection of an abdominal aortic aneurysm and placement of an aortobifemoral bypass graft under a combination of epidural and general anesthesia. Epidural morphine was administered postoperatively for pain management. The patient suffered a massive myocardial infarction (MI) in the immediate postoperative period but experienced no chest pain or discomfort similar to her usual anginal symptoms. The use of epidural and spinal opioids in the treatment of anginal pain is reviewed and discussed in terms of the possibility that such epidural opioid therapy may have masked this patient's anginal symptoms.
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Randomized Controlled Trial Comparative Study Clinical Trial
Anesthesia for craniotomy: total intravenous anesthesia with propofol and alfentanil compared to anesthesia with thiopental sodium, isoflurane, fentanyl, and nitrous oxide.
To compare a total intravenous (IV) anesthetic technique based on propofol and alfentanil with a commonly used anesthetic technique for craniotomy. ⋯ A total IV anesthetic technique with propofol and alfentanil is a valuable alternative to a more commonly used technique based on thiopental sodium, N2O, fentanyl, and isoflurane.
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Randomized Controlled Trial Comparative Study Clinical Trial
Postoperative pain control with methadone following lower abdominal surgery.
To describe a technique for the use of methadone during and following lower abdominal surgery that integrates its pharmacokinetic and pharmacodynamic properties with the objective of postoperative analgesia; to compare methadone with morphine for postoperative pain control. ⋯ Sustained analgesia with methadone is predicted by its pharmacokinetics. Patients who received 22 +/- 2.9 mg of IV methadone (combined intraoperative and recovery room doses) reported less pain and required minimal additional analgesic over the next 72 hours than did patients who received morphine. This is consistent with sustained therapeutic plasma levels due to methadone's long plasma half-life (54 +/- 20 hours). Use of methadone in this manner is an effective therapy for postoperative pain control and is not associated with toxicity or notable side effects.