Journal of anesthesia
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Journal of anesthesia · Jan 2009
Recovery of dynamic balance after general anesthesia with sevoflurane in short-duration oral surgery.
Recovery of dynamic balance, involving adjustment of the center of gravity, is essential for safe discharge on foot after ambulatory anesthesia. The purpose of this study was to assess the recovery of dynamic balance after general anesthesia with sevoflurane, using two computerized dynamic posturographies. ⋯ The recovery times for dynamic balance and psychomotor function seem to be within 150 min after emergence from general anesthesia with sevoflurane in patients undergoing oral surgery of less than 2-h duration.
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Journal of anesthesia · Jan 2009
Case ReportsLife-threatening hemothorax resulting from right brachiocephalic vein perforation during right internal jugular vein catheterization.
We present a life-threatening case of hemothorax resulting from right brachiocephalic vein perforation during right internal jugular vein catheterization. We considered that the guidewire had punctured the right brachiocephalic vein extraluminally and the catheter inserted over the guidewire had enlarged the size of the perforation. Despite the use of proper technique, an angle-tip guidewire may perforate the venous wall. Therefore, when there is negative aspiration after central venous catheterization, it is important to perform an emergency chest radiograph before proceeding with surgery; it is also important not to use an angle-tip guidewire.
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During hyperthermic intraperitoneal chemotherapy (HIPEC), we observed a partial recovery from neuromuscular block in a hyperthermic patient after hours of monitored adequate surgical relaxation and continuous infusion of atracurium during normothermia. This recovery is indicative of the higher clearance of atracurium during hyperthermia. ⋯ Moreover, this report illustrates the importance of monitoring muscle relaxation during HIPEC. Clinicians should be aware that the usual continuous infusion rate of atracurium at 0.3 mg.kg(-1).h(-1) may be inadequate in hyperthermic patients.
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Journal of anesthesia · Jan 2009
Decreased incidence of headache after unintentional dural puncture in patients with cesarean delivery administered with postoperative epidural analgesia.
To investigate how subsequent placement of a catheter into the epidural space after unintentional dural puncture for postoperative analgesia for 36-72 h affected the incidence of post-dural puncture headache (PDPH). ⋯ Subsequent catheter placement into the epidural space after unintentional dural puncture in cesarean delivery and leaving the catheter for postoperative analgesia for 36-72 h may reduce the incidence of PDPH.
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Journal of anesthesia · Jan 2009
Comparative StudyAuditory evoked potentials index versus bispectral index during propofol sedation in spinal anesthesia.
It is still controversial whether an electroencephalogram could be a useful monitor of sedation levels. The present study was performed to compare the bispectral index (BIS) and the auditory evoked potentials index (AAI) during light sedation with propofol infusion in spinal anesthesia. ⋯ The AAI, but not the BIS, could discriminate slight changes of consciousness during light sedation with propofol infusion in patients with spinal anesthesia.