Articles: patients.
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Journal of anesthesia · Sep 1994
High incidence of postoperative pulmonary complications after orthotopic liver transplantation in children.
Postoperative pulmonary complications were investigated in a total of 41 pediatric recipients who underwent orthotopic liver transplantation (OLT) between January, 1990 and March, 1992 at the Royal Children's Hospital, Brisbane. Atelectasis was seen in 40 cases (98%) of the 41 recipients, and occurred in the left lower lobe in 28 cases (68%), and in the right upper lobe in 25 cases (61%). Radiographic pulmonary edema occurred on 23 occasions in 18 recipients (45%). ⋯ Pneumothorax occurred in three cases. Pyothorax, hemothorax, bronchial asthma, and subglottic granulation occurred in one case each. The present study demonstrated that postoperative pulmonary complications are frequently observed in pediatric recipients undergoing OLT.
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Journal of anesthesia · Sep 1994
A comparative study of the efficacy of postoperative analgesia with intraoperative epidural lidocaine with or without morphine.
We compared postoperative analgesia in 15 patients (group A) who were given intraoperative epidural morphine 3 mg and lidocaine 150 mg after laminectomy/discectomy with that of 15 patients (group B) who were given only epidural lidocaine 150 mg. Epidural administration was accomplished by direct placement of the epidural catheter into the epidural space under direct vision during surgery. ⋯ There was no difference in the observed side effects in the two groups. We conclude that postoperative pain relief following laminectomy/discectomy is superior when epidural morphine is added to lidocaine than when lidocaine is being used alone.
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Journal of anesthesia · Sep 1994
Assessment of postoperative pain: Contributing factors to the differences between patients and doctors.
This study was undertaken to compare the assessment of pain intensity by 50 patients and by their doctors according to a visual analog scale 5 h and 20 h after major abdominal surgery, and to examine the relationships between the differences in rating of patients and doctors and the factors inherent in the patients which include preoperative expectation of pain, level of anxiety, and the surgical history of the patient. The ratings given by the patients were significantly higher than those given by the doctors at both time periods. ⋯ The results of analysis using Hayashi's quantification theory Type II indicated a moderate association between the rating difference and the patient's age, surgical history, preoperative state of anxiety, and expectation of pain. It is concluded that postoperative pain management, whether in clinical practice or in research, necessitates more consideration of the several above-mentioned individual factors and a preoperative interview in which the patient's level of anxiety and the amount of information the patient has concerning the surgery and post-operative pain is clearly assessed.
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Journal of anesthesia · Sep 1994
The effect of prostaglandin E1 on the increase of serum lactate and plasma granulocyte elastase activity during radical surgery for esophageal cancer.
Serum lactate concentrations and the lactate/pyruvate (L/P) ratio were measured in two groups of patients undergoing radical esophagectomy, as an indicator of tissue hypoxia, and β-glucuronidase and granulocyte elastase as indicators of tissue damage. One group received prostaglandin E1 (PGE1) and the other group received nothing. Serum lactate concentrations and the L/P ratio increased significantly 30 min after starting thoracotomy in the patients who were not treated with PGE1. ⋯ There was no change in serum β-glucuronidase activity in both groups. This study suggests that low doses of PGE1 maintain organ blood flow without affecting blood pressure. However, these low doses of PGE1 could not suppress granulocyte elastase release.
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In 92 migraine patients and 44 healthy control subjects we recorded regional cerebral blood flow (rCBF) with single photon emission computerized tomography and (133) Xe inhalation or with i.v. (99m) Tc-HMPAO. Migraine patients were studied interictally. A quantitated analysis of right-left asymmetry indices in a fixed set of regions of interest was compared with the normal asymmetry indices in the healthy controls. ⋯ Two conclusions emerged: (1) visual evaluation of interictal migraine rCBF images is insufficient to pick up abnormalities; (2) almost 50% of the migraine sufferers had abnormal rCBF/asymmetries. However, these are discrete compared with those typically seen during the aura phase of a migraine attack. One explanation to the patchy rCBF patterns might be that they reflect interictal cerebrovascular dysregulation which might to be a common feature in both types of migraine.