Journal of clinical anesthesia
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Substance abuse has crossed social, economic, and geographic borders and--throughout the world--remains one of the major problems facing society today. The prevalence of substance abuse in young adults (including women) has increased markedly over the past 20 years. ⋯ The diverse clinical manifestations of drug abuse combined with physiologic changes of pregnancy, and pathophysiology of coexisting pregnancy-related disease may lead to life-threatening complications and significantly impact the practice of obstetrical anesthesia. Regardless of the drug(s) ingested and clinical manifestations, it is always difficult to predict the exact anesthetic implications in chemically dependent patients.
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Randomized Controlled Trial Clinical Trial
Unilateral spinal block for outpatient knee arthroscopy: a dose-finding study.
To evaluate the onset time, success rate, and recovery profile of unilateral spinal anesthesia produced with 4 mg, 6 mg, and 8 mg of 0.5% hyperbaric bupivacaine. ⋯ Hyperbaric bupivacaine 4 mg injected slowly through pencil-point directional needles in patients who are maintained in the lateral decubitus position for 15 minutes provided a surgical block that was mostly restricted to the operative side and adequate to perform knee arthroscopy, with a faster recovery profile than when a 6 mg or 8 mg dose was used.
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Randomized Controlled Trial Clinical Trial
Tracheoscopy with the rapiscope to verify endotracheal tube placement.
To determine whether tracheoscopy is an accurate and quick method for verifying correct placement of the tracheal tube after intubation. ⋯ Tracheoscopy is a reliable method for quickly verifying proper endotracheal placement of a tracheal tube.
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Comparative Study Clinical Trial
A comparison of three techniques for acute postoperative pain control following major abdominal surgery.
To compare the analgesic efficacy of a nonsteroidal antiinflammatory drug (NSAID) alone (basic pain treatment) with that of NSAID in conjunction with either intravenous (IV) patient-controlled analgesia (IV-PCA) or intermittent epidural morphine (epidural morphine), among patients recovering from major intraabdominal surgery; and to assess the fixed and variable costs of providing the respective acute pain treatment modalities. ⋯ Considering the respective pain profiles, complication rates, and institutional costs associated with the three analgesic regimens analyzed, the basic pain Treatment alone constitutes a useful alternative to the other two analgesic regimens assessed.
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Comparative Study Clinical Trial
Predicting recovery from deep neuromuscular block by rocuronium in the elderly.
To determine the influence of aging on the relationship between posttetanic count (PTC) and train-of-four (TOF) response during intense neuromuscular blockade caused by rocuronium. ⋯ Posttetanic twitch stimulation is a useful method of monitoring intense neuromuscular blockade caused by rocuronium in both age groups. The interval between the earliest appearance of a posttetanic response and the first response to TOF stimulation (T1) is greater in the elderly than in the young.