Journal of clinical anesthesia
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Randomized Controlled Trial Clinical Trial
Patient-controlled bupivacaine wound instillation following cesarean section: the lack of efficacy of adjuvant ketamine.
To assess the analgesic efficacy of ketamine when administered as an adjuvant to bupivacaine for patient-controlled wound instillation following cesarean section. ⋯ Adjuvant local ketamine does not enhance bupivacaine-induced wound instillation following cesarean section.
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To assess the impact of a new postanesthesia care unit (PACU) on intensive care unit (ICU) utilization, hospital length of stay, and complications following major noncardiac surgery. ⋯ Increased availability of PACU beds resulted in reduced utilization of ICU resources without compromising patient care after major noncardiac surgery.
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We report the successful use of nalbuphine, a mu-receptor antagonist-kappa-receptor agonist, to reverse the adverse effects on the bladder of epidural morphine.
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A 76-year-old woman underwent double-lumen endotracheal tube intubation for right upper lobectomy. During one-lung ventilation, she developed tension pneumothorax on her dependent lung and suffered cardiac arrest. The presenting signs of tension pneumothorax--hypoxemia, hypotension, and increased airway pressure--are relatively common during this procedure, leading to a delay in diagnosis and effective treatment. When all three signs occur together during one-lung ventilation, cardiovascular collapse can result and serious consideration must be given to the diagnosis of tension pneumothorax in the dependent lung.
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Several potential complications may occur during identification of the epidural space. We present a case of subarachnoid pneumocephalus as a rare complication of epidural catheter placement.