Minerva anestesiologica
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Minerva anestesiologica · Dec 2010
Case ReportsParesis of cranial nerve VI (N. abducens) after thoracic dural perforation.
Epidural anesthesia is associated with the risk of unintended dural perforation and concomitant leakage of cerebrospinal fluid (CSF) from the subarachnoidal space. This may remain asymptomatic or trigger post-dural puncture headache (PDPH). ⋯ Herein, diagnosis of N. abducens paresis was probably delayed because the optical symptoms, such as blurred and double vision, were attributed to optical hallucinations caused by a concomitant (S)-ketamine infusion. In all patients with optical symptoms such as blurred or double vision a paresis of the abducens nerve should be considered.
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Minerva anestesiologica · Dec 2010
Ex vivo changes in blood glucose levels seldom change blood glucose control algorithm recommendations.
Hyperglycemia and glycemic variabilities are associated with adverse outcomes in critically ill patients. Blood glucose control with insulin mandates an adequate and precise assessment of blood glucose levels. Blood glucose levels, however, can change ex vivo after sampling. The aim of this study was to determine whether this phenomenon affects the practice of blood glucose control. ⋯ Ex vivo changes in blood glucose levels, although statistically significant, seem clinically irrelevant.