Anesthesiology and pain medicine
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Alterations in taste and smell, including but not limited to anosmia, ageusia, hypogeusia, and dysgeusia, have been described in association with various medications, including anesthetic agents. Frequently, these symptoms occur 1-2 weeks after medication administration and last several months. While such a phenomenon is a rare occurrence, it nonetheless can significantly impact patients' satisfaction and quality of life. ⋯ Based on available literature recommendations for anesthesiologists caring for patients at risk for this occurrence are presented in this review. The symptoms are usually temporary as in the majority of the patients the sensory receptor cells are able to regenerate themselves after injury. Anesthesia providers need to aware of this phenomenon to be able to reassure patients and possibly avoid anesthetic techniques associated with anosmia and ageusia.
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Cognitive disorder is a fluctuating cognitive destruction and a common problem for hospitalized patients, which leads to loss of consciousness. It is usually accompanied with increased mortality, prolonged hospital stay, and decreased rehabilitation. ⋯ Given the significant prevalence of postoperative cognitive disorder and significant associatio n between the history of high blood pressure, C-reactive protein and preoperative creatinine and cognitive disorder, detection of patient's clinical symptoms may improve diagnosis, treatment and prevention of this disorder.
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Spinal anesthesia (SA) is the most common regional anesthesia (RA) conducted for many surgical procedures. ⋯ It seems that considering the clinical examination of patients before SA focusing on lumbar spinous process status, presence of lumbar deformity, calculation of BMI and radiological signs of lumbar vertebrae can be helpful in predicting SA difficulty.
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Spinal anesthesia has been associated with intraoperative nausea and vomiting (IONV), especially during cesarean section, which is attributed to several mechanisms. ⋯ Subhypnotic doses of midazolam or propofol are effective in the prevention of nausea and vomiting during and after cesarean section with spinal anesthesia and does not significantly influence hemodynamic of the patients.
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Gasretention in the peritoneal cavity plays an important role in inducing postoperative pain after laparoscopy, which is inevitably retained in the peritoneal cavity. ⋯ We conclude that volume of residual pneumoperitoneum is a contributing factor in the etiology of postoperative pain after laparoscopic cholecystectomy.