AANA journal
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Randomized Controlled Trial Comparative Study Clinical Trial
Postoperative nausea and vomiting: a comparison of propofol infusion versus isoflurane inhalational technique for laparoscopic patients.
Gynecologic laparoscopic procedures frequently precipitate postoperative nausea and/or vomiting. The use of specific anesthetic agents and premedicants may decrease the incidence. This study determined the occurrence of postoperative nausea/retching/vomiting (N/R/V) when propofol was used for anesthesia maintenance compared with isoflurane when both groups of patients received metoclopramide and ranitidine preoperatively and were induced with propofol. ⋯ No significant difference in the incidence of N/R/V was demonstrated between the propofol and isoflurane groups (P < 0.05). Sixty percent of the patients who received meperidine in the recovery room experienced nausea and/or vomiting. The use of propofol versus isoflurane for maintenance of anesthesia had no effect on the incidence of postoperative N/R/V when patients were premedicated with metoclopramide and ranitidine.
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There are circumstances when induction of general anesthesia followed by direct laryngoscopy and intubation is contraindicated. This case report describes and presents a protocol for a method of endotracheal intubation that combines the benefits of light wand and fiberoptic techniques. The patient was a 73-year-old male with a history of two cervical fusions. ⋯ The bronchoscope allowed direct visualization of the pharyngeal, laryngeal, and tracheal anatomy. Since our initial experience, the hybrid technique has been modified by replacing the light wand with a conventional stylet. Subsequent uses of the technique have been successful and free of complications.
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Review Case Reports
Tympanic membrane rupture following general anesthesia with nitrous oxide: a case report.
Although rare, tympanic membrane rupture during general anesthesia with nitrous oxide has been reported previously in the literature. Nitrous oxide administration and the effects on closed body cavities will be reviewed. Key factors in patient assessment which can determine safe use of nitrous oxide in the clinical setting will also be discussed.