Journal of clinical anesthesia
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Use of single-dose and continuous interscalene brachial plexus block (ISB) are gaining widespread popularity. When compared with general anesthesia, ISB has been reported to provide superior postoperative analgesia with fewer side effects, and it is associated with greater patient satisfaction. Anatomical landmarks are readily identifiable, which contributes to the ease of performing this block. In the future, we anticipate increased use of continuous interscalene catheters or injection of biodegradable local anesthetic impregnated microspheres to provide prolonged perioperative outpatient analgesia.
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We report two cases of overdoses of intramuscular midazolam used as a premedication. Both cases had no resedation or complications, but the accidents happened as a result of a resident and nurse's lack of experience with midazolam. The intramuscular doses, given at four times the normal quantity, fortunately caused no harm in our cases. However, the situations suggest that we should carefully check the dosage and review the correct procedures, even when using a drug that is considered to be familiar with most practitioners.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
A comparison of the remifentanil and fentanyl adverse effect profile in a multicenter phase IV study.
To compare the frequency of adverse effects of remifentanil and fentanyl in a large and diverse patient population. ⋯ In the doses used, both remifentanil and fentanyl have a similar frequency of adverse effects except for the higher frequency of hypotension associated with the use of remifentanil.
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Randomized Controlled Trial Clinical Trial
Effect of maintenance bolus on the recovery profile of a short-acting nondepolarizing muscle relaxant.
To evaluate the effect of different maintenance boluses of a short-acting nondepolarizing neuromuscular blocking drug on its spontaneous recovery profile during anesthesia. ⋯ Spontaneous recovery of the T(1) to 25% of the baseline value occurred 6 to 10 minutes after a maintenance bolus dose of rapacuronium 0.25 to 0.75 mg x kg(-1) i.v. However, recovery to a TOF>0.7 required 44 to 66 minutes during desflurane anesthesia.