Journal of clinical anesthesia
-
Randomized Controlled Trial Clinical Trial
The effects of remifentanil and alfentanil-based total intravenous anesthesia (TIVA) on the endocrine response to abdominal hysterectomy.
To compare the effects of remifentanil with alfentanil as a part of total intravenous anesthesia (TIVA) on plasma concentrations of cortisol, insulin, and glucose, and hemodynamic responses in patients undergoing abdominal hysterectomy. ⋯ Remifentanil provided better hemodynamic stability than alfentanil during anesthesia and surgery. However, both remifentanil and alfentanil had similar effects on the stress endocrine response to abdominal hysterectomy.
-
To evaluate the correlation between accepted screening tests for difficult tracheal intubation and ease of intubation with a lightwand blind technique. ⋯ Mallampati class III airway significantly increases time to intubation when the transillumination technique is used. BMI > or = 30 kg/m2 is another factor that interferes with the ease and success of intubation with this technique.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Cardiovascular changes after extraglottic airway insertion: a prospective, randomized comparison between the laryngeal mask or the new PAXpress.
To compare hemodynamic responses induced with the new extraglottic airway, PAXpress, and the classic Laryngeal Mask Airway (LMA). ⋯ Although further studies are required to evaluate safety and airway trauma of this new extraglottic airway, placing the PAXpress produces more marked changes in hemodynamic variables as compared with those produced by the LMA.
-
We describe a 67-year-old woman with cholangiocarcinoma who was scheduled for cholecystectomy, trisegmentectomy, bile duct resection, and regional lymphadenectomy. Her case was complicated by hyperlactatemia, sepsis, and multiorgan failure. The discussion reviews the possible causes of the hyperlactatemia and reviews measures that could be used to reduce this risk.
-
Case Reports
Spinal epidural hematoma occurrence in the absence of known risk factors: a case series.
Spinal epidural hematoma in the absence of coagulopathy or anticoagulation therapy is an extremely rare occurrence, with a reported incidence of less than 1 in 1 million. We present seven cases of documented epidural hematoma in the absence of coagulopathy or anticoagulation therapy to alert the clinician to consider spinal or epidural hematoma when suspicious signs and symptoms are present after neuraxial block in the absence of coagulopathy or anticoagulation therapy. The need for immediate diagnosis and therapy is emphasized as the only potential for meaningful recovery.