Articles: postoperative.
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Rev Bras Anestesiol · Apr 2004
[Remifentanil versus dexmedetomidine as coadjutants of standardized anesthetic technique in morbidly obese patients.].
Two coadjuvant anesthetic drugs - remifentanil and dexmedetomidine - were compared in terms of anesthetic recovery, arterial pH and PaCO2 evolution, in morbidly obese patients submitted to Capella's surgery. ⋯ In the studied population, the association of remifentanil to standardized anesthetic technique has resulted in faster anesthetic recovery, stability of preoperative arterial PaCO2 values during the immediate postoperative period and lower postoperative rescue analgesics consumption, as compared to dexmedetomidine.
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Individual patient meta-analysis to determine the analgesic efficacy and adverse effects of single-dose rofecoxib in acute postoperative pain. ⋯ Single-dose rofecoxib 50 mg is an effective treatment with long-lasting analgesia and few adverse effects in dental pain. More information is required to confirm efficacy in postsurgical pain.
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To discuss the pathophysiology, risk factors, and treatments for atrial fibrillation occurring after cardiac surgery. ⋯ Atrial fibrillation is one of the most common complications of cardiac surgery. There are three major aims for treating atrial fibrillation: conversion to sinus rhythm, heart rate control, and anticoagulation. Only beta-blockers can be recommended for prophylaxis against postoperative atrial fibrillation. Further refinements in surgical treatments for atrial fibrillation may allow for wider applications of this therapy with lower rates of complications.
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Recent articles indicate that at the present time disastrous respiratory outcomes during the perioperative management of patients with obstructive sleep apnea are a major problem for the anesthesia community. ⋯ Adult obese patients with suspected or sleep test confirmed obstructive sleep apnea present a formidable challenge throughout the perioperative period. Tracheal intubation and extubation decisions in obese patients with either a presumptive or sleep study diagnosis of obstructive sleep apnea must be made within the context that there may be excess tissue in the pharynx. If opioids are used in the extubated postoperative obese patient with sleep apnea, then one must seriously consider the need for continuous visual and electronic monitoring. Institutional and national society guidelines on these matters are badly needed.
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Rev Bras Anestesiol · Feb 2004
Epidural abscess after patient-controlled epidural analgesia. Case report.
Epidural analgesia is often used to control postoperative pain or to manage chronic pain in oncologic patients. However, it is not free from complications. This case reports a young healthy female patient submitted to epidural analgesia in patient-controlled infusion pump, which developed epidural abscess requiring surgical decompression. ⋯ Epidural analgesia often used to control postoperative or chronic pain, although very effective, is not free from severe, although rare complications, such as epidural abscess.