Articles: postoperative.
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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.
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Postoperative vomiting remains a common complication of general anesthesia and occurs more frequently in children than adults. Prophylactic antiemetics have limited efficacy and have a potential for side effects. The new 5 HT3 antagonists are effective but expensive, while the older less expensive drugs such as droperidol have come under disrepute because of the potential for serious, life-threatening, cardiac arrhythmias. This review examines the literature to aid practicing anesthesiologists in the choice of patient who will benefit from prophylactic antiemetics. ⋯ Anesthesiologists should practice evidence-based medicine in reducing the common anesthetic complication of postoperative vomiting by an individualized approach that balances the choice of drugs with the expected risk of postoperative vomiting for cost-effective management.
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Curr Opin Anaesthesiol · Dec 2003
Peripheral nerve block for ambulatory surgery and postoperative analgesia.
With this article we intend to increase the awareness of the efficiency and efficacy of peripheral nerve block as a treatment option for outpatient surgical anesthesia and postoperative home-based analgesia. ⋯ The recent advances and techniques described indicate that peripheral nerve block is both a valid and frequently a preferred option for ambulatory surgery.
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Rev Bras Anestesiol · Dec 2003
[Post-cesarean section analgesia with low spinal morphine doses and systemic nonsteroidal anti-inflammatory drug: diclofenac versus ketoprofen.].
The association of low spinal morphine doses and muscular diclofenac is effective to control postoperative pain after Cesarean section under spinal anesthesia. Ketoprofen, also an NSAID, may be advantageous over diclofenac because it may be intravenously administered. This study aimed at comparing the analgesic efficacy of diclofenac and ketoprofen in association to low spinal morphine doses in the immediate postoperative period of patients submitted to Cesarean section under spinal anesthesia. ⋯ When associated to low spinal morphine doses, ketoprofen was similar to diclofenac in providing postoperative analgesia in the first six hours following Cesarean section under spinal anesthesia.