Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of fentanyl-propofol with a ketamine-propofol combination for sedation during endometrial biopsy.
The purpose of this study was to compare the clinical activities of ketamine and fentanyl when used in combination with propofol for outpatients undergoing endometrial biopsy. The investigated parameters were respiration, sedation, recovery rate, side effects, time to discharge, and patient satisfaction. ⋯ Hemodynamic change and degrees of sedation showed that fentanyl-propofol and ketamine-fentanyl combinations can be used safely in patients undergoing endometrial biopsy. However, with regard to side effects and patient satisfaction, the fentanyl-propofol was superior.
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To investigate whether CD11b on neutrophils can be used as a marker to predict myocardial ischemia-reperfusion injury for patients undergoing coronary artery bypass graft (CABG) surgery on cardiopulmonary bypass (CPB). ⋯ CD11b expression on neutrophils may not be a reliable predictor for myocardial ischemia-reperfusion injury in CABG surgery on CPB because of the possible sequestration of neutrophils in myocardium.
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Randomized Controlled Trial Clinical Trial
Addition of 0.1% bupivacaine to buprenorphine and droperidol in patient-controlled epidural analgesia improved postoperative pain scores on coughing after gynecological surgery.
To compare the analgesic efficacy of additional 0.1% bupivacaine to patient-controlled epidural analgesia (PCEA) using buprenorphine and droperidol after gynecological surgery. ⋯ Addition of 0.1% bupivacaine to PCEA using buprenorphine and droperidol provides better analgesia on coughing after gynecological surgery.
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Case Reports
Neostigmine-induced prolonged neuromuscular blockade in a patient with atypical pseudocholinesterase.
A patient with unrecognized atypical pseudocholinesterase was given succinylcholine and then vecuronium before neuromuscular monitoring was instituted. Subsequently, when neostigmine and glycopyrrolate were given to reverse what was thought to be a nondepolarizing block, the patient became further relaxed, and his trachea could not be extubated for more than 10 hours. In this report, we discuss drug interactions, phase II block, and the importance of timely neuromuscular monitoring.
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This case involves cardiac arrest of a 29-week old pregnant African American woman, occurring 2 days after surgical correction of an incarcerated ventral hernia with small bowel obstruction. The patient could not be resuscitated from this arrest. Details of the case are presented, and diagnostic and unique management considerations for this uncommon occurrence are set forth.