MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Journal of Clinical Anesthesia' source. Wed, 08 Feb 2012 07:39:20 +0100 http://www.medworm.com/index.php?rid=5637949&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011004119%2Fabstract%3Frss%3Dyes Electrical velocimetry is a new type of impedance cardiography, which is easy to use and noninvasive. In 6 nonobstetric studies, electrical velocimetry correlated well with more established methods of measuring cardiac output (CO) such as thermodilution and echocardiography . In obstetrics, electrical velocimetry has been used to measure the hemodynamic changes associated with intravenous (IV) magnesium sulfate, hydralazine, and labetalol in preeclampsia , IV indigo carmine during bladder repair , and during an episode of fetal heart rate (HR) deceleration associated with magnesium administration . (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5637949 Sun, 29 Jan 2012 12:15:49 +0100 5637949 http://www.medworm.com/index.php?rid=5637946&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011004090%2Fabstract%3Frss%3Dyes A rare cause of light failure in a Macintosh 4 blade during direct laryngoscopy is reported. Laryngoscope malfunction is a frequently encountered equipment failure in the operating room . The usual causes of laryngoscope malfunction encountered are a failing light source, defective bulb, or faulty contact between the blade and the handle or in the socket . In another case, the blade separated at the weld line, causing the laryngoscope to be fractured . (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5637946 Sun, 29 Jan 2012 12:15:49 +0100 5637946 http://www.medworm.com/index.php?rid=5637945&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011004089%2Fabstract%3Frss%3Dyes We read with interest the recent paper of Min et al , regarding the use of a small dose of propofol on intubation conditions. They studied 102 ASA physical status 1 and 2 patients undergoing elective surgery with general anesthesia and found that administration of an additional dose of propofol (0.5 mg/kg) before intubation may significantly improve intubation conditions without increasing the frequency of hypotension. However, is this approach the most appropriate for anesthesia induction? (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5637945 Sun, 29 Jan 2012 12:15:49 +0100 5637945 http://www.medworm.com/index.php?rid=5637944&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011004053%2Fabstract%3Frss%3Dyes I read with keen interest the article by Max et al., regarding the inadequacies of the personal statement in predicting success during residency . Their finding, that the personal statement in the typical anesthesiology residency application revolves around one of 13 common themes and that most essays share common elements, surely resonates with members of Resident Selection Committees. The commonality noted across the essays limits their utility in distinguishing between candidates. In addition, over one in 20 essays contains elements of plagiarism . (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5637944 Sun, 29 Jan 2012 12:15:49 +0100 5637944 http://www.medworm.com/index.php?rid=5637943&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011004077%2Fabstract%3Frss%3Dyes We describe of our course structure and content as a potentially useful template. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5637943 Sun, 29 Jan 2012 12:15:49 +0100 5637943 http://www.medworm.com/index.php?rid=5637940&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS095281801100331X%2Fabstract%3Frss%3Dyes Abstract: A 45 year old man with metastatic colon cancer presented with uncontrollable abdominal wall pain. Transversus abdominis plane (TAP) block with ropivacaine and methylprednisolone was performed with excellent pain relief, which allowed a significant weaning of the patient's opioid requirements. A second TAP block was performed with a 33% ethanol solution (ethanol and ropivacaine) with excellent pain relief. The neurolytic block appeared to offer better pain control for more than 5 days after placement until the patient finally succumbed to his illness. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5637940 Sun, 29 Jan 2012 12:15:49 +0100 5637940 http://www.medworm.com/index.php?rid=5637939&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003357%2Fabstract%3Frss%3Dyes Abstract: The development of acute respiratory failure (ARF) secondary to respiratory tract infection is a common event in patients affected with osteogenesis imperfecta type III. Noninvasive positive pressure ventilation (NPPV) is increasingly administered to treat severe ARF of various origin. The use of NPPV in two patients with severe ARF secondary to osteogenesis imperfecta type III is presented. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5637939 Sun, 29 Jan 2012 12:15:49 +0100 5637939 http://www.medworm.com/index.php?rid=5637938&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003321%2Fabstract%3Frss%3Dyes Abstract: Propofol is widely used for sedating critically ill adult patients because of its rapid onset and short recovery times, even after prolonged use. Propofol may be associated with a life-threatening syndrome, propofol-related infusion syndrome (PRIS), which includes cardiac failure, severe metabolic acidosis, renal failure, and rhabodomyolysis. The pathophysiology is incompletely understood. Propofol-related infusion syndrome seems to be dose-related, and it occurs generally in patients undergoing long-term (> 48 hrs) sedation at higher doses (> 4 mg/kg/hr). A case of PRIS in a patient after severe head injury is presented. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5637938 Sun, 29 Jan 2012 12:15:49 +0100 5637938 http://www.medworm.com/index.php?rid=5637937&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003680%2Fabstract%3Frss%3Dyes Conclusions: Ultrasound guidance was associated with less local anesthetic consumption than with the nerve stimulator; however, there was little clinical benefit, as all other outcomes were similar between groups. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5637937 Sun, 29 Jan 2012 12:15:49 +0100 5637937 http://www.medworm.com/index.php?rid=5637936&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003679%2Fabstract%3Frss%3Dyes Conclusions: Anesthesiology residents have an interest in residency and fellowship GHO programs. Formalization of GHO programs during training may reduce work-related barriers associated with GHO participation and broaden academic program recruitment. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5637936 Sun, 29 Jan 2012 12:15:49 +0100 5637936 http://www.medworm.com/index.php?rid=5637935&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003667%2Fabstract%3Frss%3Dyes Conclusion: BMI correlates with BP elevation during ECT. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5637935 Sun, 29 Jan 2012 12:15:49 +0100 5637935 http://www.medworm.com/index.php?rid=5637934&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003655%2Fabstract%3Frss%3Dyes Conclusion: Both drugs are acceptable choices for pain control in patients undergoing second trimester abortions. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5637934 Sun, 29 Jan 2012 12:15:49 +0100 5637934 http://www.medworm.com/index.php?rid=5637933&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003643%2Fabstract%3Frss%3Dyes Conclusion: The curve of the Boedeker Intubation Forceps allows both the tip of the forceps and the glottic opening to be simultaneously visible in the field of view during videolaryngoscopy, making removal of glottic foreign bodies easier. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5637933 Sun, 29 Jan 2012 12:15:49 +0100 5637933 http://www.medworm.com/index.php?rid=5637932&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003631%2Fabstract%3Frss%3Dyes Conclusions: Using remifentanil as the sole analgesic allows evaluation of the larynx with direct laryngoscopy in a conscious patient. A poor Cormack-Lehane grade in a conscious patient may or may not improve with general anesthesia. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5637932 Sun, 29 Jan 2012 12:15:49 +0100 5637932 http://www.medworm.com/index.php?rid=5637931&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003242%2Fabstract%3Frss%3Dyes Conclusion: Gitelman syndrome is a mild disorder when appropriately managed. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5637931 Sun, 29 Jan 2012 12:15:49 +0100 5637931 http://www.medworm.com/index.php?rid=5637929&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003266%2Fabstract%3Frss%3Dyes Conclusion: Anesthetic technique does not appear to significantly affect postoperative NK T lymphocyte function. Given the heterogeneity observed, further clinical studies in cancer patients of the effect of anesthetic technique on immune function in general, and NK T lymphocyte function in particular, are needed. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5637929 Sun, 29 Jan 2012 12:15:49 +0100 5637929 http://www.medworm.com/index.php?rid=5637927&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818012000335%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5637927 Sun, 29 Jan 2012 12:15:49 +0100 5637927 http://www.medworm.com/index.php?rid=5637926&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818012000323%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5637926 Sun, 29 Jan 2012 12:15:49 +0100 5637926 http://www.medworm.com/index.php?rid=5637952&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011004144%2Fabstract%3Frss%3Dyes Microcuff tracheal tubes (MTT) with an ultra-thin, high volume-low pressure cuff are now routinely used in the care of pediatric patients. The Murphy eye is omitted from the MTT to incorporate the cuff without adding additional length, so as to keep the tip at a safe distance from the carina (Magill tube) . We share our experience in a complex-airway patient, where a major airway problem was overcome by artificially creating a Murphy eye in a MTT. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5637952 Thu, 12 Jan 2012 05:00:00 +0100 5637952 http://www.medworm.com/index.php?rid=5637950&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011004132%2Fabstract%3Frss%3Dyes Several cost-saving and cost-containment studies have focused on reducing unnecessary costs through practice modifications during the perioperative period . In chronic pain management, cost-cutting proposals involving capital investments rather than clinical decision-making must be considered. Cost-cutting investment decisions are intended to improve cost-effectiveness and efficiency by reducing labor or material costs . To reduce costs and improve revenue cycle management in the hospital ambulatory and emergency department settings, self-serve, digital, touch screen kiosks have been implemented . These kiosks expedite the check-in process by allowing patients to preregister, make payments, and update information . In the chronic pain management setting, these functions may be accomplished... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5637950 Thu, 12 Jan 2012 05:00:00 +0100 5637950 http://www.medworm.com/index.php?rid=5637948&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011004107%2Fabstract%3Frss%3Dyes Since 1994, various case reports, pilot studies, and clinical trials have documented the efficacy and safety of ketamine in the treatment of chronic neuropathic pain . Due to its unique mechanism of action, ketamine is a highly interesting drug for the treatment of therapy-resistant chronic pain syndromes, and it may be administered in various ways, such as via oral, sublingual, intranasal, rectal, and transdermal routes. Long periods of decreased pain may be induced by relatively short courses of ketamine intravenously (IV). Complex Regional Pain Syndrome Type 1 patients suffering from severe pain were successfully treated for 4 days with a continuous infusion of low-dose S-ketamine over 11 weeks, without a reemergence of their pain. However, one of the troublesome clinical aspects of (IV... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5637948 Mon, 09 Jan 2012 05:00:00 +0100 5637948 http://www.medworm.com/index.php?rid=5637947&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003333%2Fabstract%3Frss%3Dyes A 46 year old woman, who appeared younger than her stated age, presented for a general anesthetic to rule out ovarian cancer. She had normal laboratory values and she denied medical or surgical history other than one diagnostic laparoscopy. The patient denied plastic surgery in front of her husband, but a chin implant surgery was noted in her chart. On the way to the operating room, she again denied any surgeries. We noted that she had chin implant, breast implant, blepharoplasty, and rhinoplasty scars. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5637947 Mon, 09 Jan 2012 05:00:00 +0100 5637947 http://www.medworm.com/index.php?rid=5637941&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003783%2Fabstract%3Frss%3Dyes Abstract: Sugammadex, a new reversal agent for rocuronium, encapsulates the rocuronium molecule and results in rapid reversal of rocuronium-induced neuromuscular blockade. A case in which sugammadex was used to treat an anaphylactic reaction that occurred after rocuronium is presented. The binding/encapsulation of rocuronium by sugammadex may selectively eliminate the antigenic quaternary ammonium activity of circulating rocuronium, and prevent the propagation of rocuronium-induced anaphylaxis. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5637941 Thu, 08 Dec 2011 05:00:00 +0100 5637941 http://www.medworm.com/index.php?rid=5637928&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS095281801100376X%2Fabstract%3Frss%3Dyes The spread of cancer involves a plethora of factors, all of which may be influenced by anesthesia. In most cases, significant exposure to anesthesia is of brief duration. However, the timing of anesthesia for oncologic surgery coincides with the stirring of the hornet's nest. It is thus intriguing to wonder if anesthesia technique has an impact on disease recurrence. Definitive clinical trials of this question will be technically formidable, but in this issue of the Journal of Clinical Anesthesia Drs. Conrick-Martin, Kell, and Buggy offer an interesting meta-analysis of a carefully chosen aspect of the overall question . They ask whether lymphocytes active against neoplastic cells are more detectable in cases in which epidural or intrathecal anesthesia/analgesia was performed in order to s... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5637928 Thu, 08 Dec 2011 05:00:00 +0100 5637928 http://www.medworm.com/index.php?rid=5637951&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011004120%2Fabstract%3Frss%3Dyes We describe a new technique with the Airtraq during an emergency. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5637951 Mon, 05 Dec 2011 05:00:00 +0100 5637951 http://www.medworm.com/index.php?rid=5637942&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003771%2Fabstract%3Frss%3Dyes Abstract: A 30 year old woman who was 8 weeks postpartum with a history of cholelithiasis and gallstone pancreatitis, and who was status-post endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy, was treated with a single-incision laparoscopic (SIL) cholecystectomy. A transversus abdominis plane block (TAP) was performed after induction of anesthesia. The patient required no intraoperative or postoperative opioids. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5637942 Fri, 02 Dec 2011 05:00:00 +0100 5637942 http://www.medworm.com/index.php?rid=5476051&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011004065%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5476051 Thu, 01 Dec 2011 05:00:00 +0100 5476051 http://www.medworm.com/index.php?rid=5476050&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002959%2Fabstract%3Frss%3Dyes Pallister-Killian syndrome (PKS) is a rare, sporadic, genetic disorder characterized by a mosaic supernumerary isochromosome 12p . Clinical manifestation of PKS varies from case to case. However, consistent anomalies include craniofacial dysmorphism, a short neck, limb deformities, pigmentary skin anomalies, and nail hypoplasia. Progressive psychomotor developmental delay, severe hypotonia, deafness, and seizures are also common characteristics . To date, approximately 70 cases of prenatally diagnosed PKS have been reported . However, more occult PKS patients than expected may exist. In a PubMed search of anesthesia-related literature using the keyword “PKS,” only 4 cases were found , and anesthetic management was uneventful irrespective of anesthetic method in all cases. Major anesthe... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5476050 Thu, 01 Dec 2011 05:00:00 +0100 5476050 http://www.medworm.com/index.php?rid=5476049&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003412%2Fabstract%3Frss%3Dyes A fair percentage of children undergo magnetic resonance imaging (MRI) during deep sedation or intravenous anesthetic without a secured airway . Children with potential cervical instability, such as those with Down syndrome, undergo MRI for diagnostic purposes without cervical spine clearance. In such children it is safer to avoid cervical manipulation, including Laryngeal Mask Airway (LMA) insertion . The most common adverse event during deep sedation without a secured airway is desaturation due to airway obstruction . End-tidal CO2 monitors may not be available in all MRI rooms; even if they are available, the tracing may not be accurate with frequent movement of the table and air dilution. Nasal prongs with CO2 monitors also may be unpredictable with the long tubing and possibility of d... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5476049 Thu, 01 Dec 2011 05:00:00 +0100 5476049 http://www.medworm.com/index.php?rid=5476048&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003400%2Fabstract%3Frss%3Dyes A case of accidental epidural injection of vecuronium is presented. A 67 year old, 49.3 kg woman was scheduled to undergo closure of an abdominal stoma during combined epidural and general anesthesia. The epidural space was entered at the Th9-Th10 intervertebral space and an epidural catheter was advanced 5 cm. The patient received 2.0 mL of lidocaine 1% epidurally as a test dose and an additional bolus of 4 mL of ropivacaine 0.75% and fentanyl 100 μg for epidural anesthesia. General anesthesia was induced with fentanyl 100 μg and propofol 80 mg. After loss of consciousness, the ulnar nerve was stimulated at the wrist with square-wave, 50 mA of 0.2 ms duration, delivered in a train-of-four (TOF) mode at 2 Hz every 15 seconds. Contraction of the ipsilateral adductor pollicis muscle was me... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5476048 Thu, 01 Dec 2011 05:00:00 +0100 5476048 http://www.medworm.com/index.php?rid=5476047&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003394%2Fabstract%3Frss%3Dyes In this report, a woman who had no history of urinary incontinence, was unable to maintain a full bladder and control micturition following a unilateral sciatic nerve block. The patient's incontinence was transient, and she regained full bladder control after resolution of the block. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5476047 Thu, 01 Dec 2011 05:00:00 +0100 5476047 http://www.medworm.com/index.php?rid=5476046&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003382%2Fabstract%3Frss%3Dyes The Poisson probability distribution is a statistical function that describes the occurrence of random events . Patient arrivals in the Postanesthesia Care Unit (PACU) are random events that follow a Poisson probability distribution . The probability of a patient arrival in the PACU is the same for any two intervals of equal length. Similarly, the end of a surgical procedure is independent of the end of any other procedure. PACU occupancy is determined by a patient admission to the PACU prior to the discharge of the next patient, and is influenced by the availability of in-hospital beds, PACU nursing staff, patient transporters, and the temporal distribution and complexities of operative cases. When the PACU is full and a new surgical procedure has ended, the patient is placed on a PACU wa... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5476046 Thu, 01 Dec 2011 05:00:00 +0100 5476046 http://www.medworm.com/index.php?rid=5476045&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003370%2Fabstract%3Frss%3Dyes We describe the anesthetic management of a patient who had both severe intrinsic and extrinsic airway compression, as well as multiple medical comorbidities, who presented to the operating room (OR) for further management of his airway disease. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5476045 Thu, 01 Dec 2011 05:00:00 +0100 5476045 http://www.medworm.com/index.php?rid=5476044&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003369%2Fabstract%3Frss%3Dyes The Airtraq laryngoscope (Prodol Meditec S.A.,Vizcaya, Spain) is a new disposable optical laryngoscope that provides a full view of the glottis without the need for aligning the oral, pharyngeal, and laryngeal axes. Different versions of the Airtraq laryngoscope are available for orotracheal and nasotracheal intubations in adult and pediatric patients, and for placement of double-lumen endobronchial tubes in adult patients. There is no significant difference in design between the devices. The Airtraq laryngoscope used for placement of a double-lumen endobronchial tube has a wider tube channel. The Airtraq laryngoscope is a useful choice for elective intubations and is often good for difficult intubations . We successfully performed orotracheal intubation using a nasotracheal device when or... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5476044 Thu, 01 Dec 2011 05:00:00 +0100 5476044 http://www.medworm.com/index.php?rid=5476043&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003424%2Fabstract%3Frss%3Dyes The Intubating Laryngeal Mask Airway (ILMA; The Laryngeal Mask Airway Co., Inc., Le Rocher, Victoria, Mahe, Seychelles) is now an accepted option in difficult-to-intubate conditions . However, the cuff of the silicone endotracheal tube (ETT), which is inserted through the ILMA, has not received sufficient attention. A difficult-to-intubate patient received replacement of a correctly placed ILMA-endotracheal tube with a Portex tube (Smiths Medical Intl, Hythe, Kent, UK) on account of the high cuff pressure in the ILMA-ETT. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5476043 Thu, 01 Dec 2011 05:00:00 +0100 5476043 http://www.medworm.com/index.php?rid=5476042&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003345%2Fabstract%3Frss%3Dyes Abstract: Myocardial ischemia in pregnancy poses a significant challenge for the anesthesiologist. It is a relatively rare disorder (approximately 180 cases published in the indexed literature since 1922) but it carries high mortality. Diagnosis is frequently hampered by diminished sensitivity of several testing modalities conventionally used to diagnose myocardial ischemia. The etiology of cardiac ischemia also is multifactorial and occurs during a very dynamic period. A case of acute coronary syndrome in a parturient during urgent cesarean delivery for placental abruption is presented, followed by a brief review of the topic. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5476042 Thu, 01 Dec 2011 05:00:00 +0100 5476042 http://www.medworm.com/index.php?rid=5476041&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003692%2Fabstract%3Frss%3Dyes Abstract: The cerebral metabolic and vascular effects of intravenous norepinephrine have been shown in an animal model using somatosensory-evoked potentials (SSEPs). A case of intravenous norepinephrine resulting in a decrease in SSEP amplitude (of greater than 50%) despite no significant change in blood pressure, prior to cross-clamping during a carotid endarterectomy is presented. This finding may have implications for the use of norepinephrine in the critical care unit as well as the operating room. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5476041 Thu, 01 Dec 2011 05:00:00 +0100 5476041 http://www.medworm.com/index.php?rid=5476040&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003308%2Fabstract%3Frss%3Dyes Abstract: A parturient presented at 35 weeks' gestation with worsening neurological symptoms caused by syringomyelia. She underwent urgent cesarean delivery. The etiology and anesthetic considerations for an obstetrical patient with syringomyelia are discussed. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5476040 Thu, 01 Dec 2011 05:00:00 +0100 5476040 http://www.medworm.com/index.php?rid=5476039&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003254%2Fabstract%3Frss%3Dyes Abstract: A case of severe hyponatremia with accompanying pulmonary edema and cardiovascular instability during a hysteroscopic myomectomy with general anesthesia is presented. The patient's sodium value decreased to 87 mmol/L. She was managed with aggressive maneuvers, including an infusion of 3% hypertonic saline. The patient's serum sodium increased to 113 mmol/L at the end of the operation, and it was increased up to 138 mmol/L at 48 hours. The patient recovered completely without neurologic sequelae. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5476039 Thu, 01 Dec 2011 05:00:00 +0100 5476039 http://www.medworm.com/index.php?rid=5476038&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003187%2Fabstract%3Frss%3Dyes Abstract: An 85 year old man with a history of chronic renal insufficiency was admitted to the cardiothoracic intensive care unit after aortic valve replacement. His postoperative course was marked by acute oliguric renal failure for high blood urea nitrogen (BUN) and acute hyperactive delirium. At this time he also developed tremors with muscle twitching; he received no other form of sedatives. A neurology consult made the diagnosis of twitch-convulsive syndrome associated with uremic encephalopathy. While the patient was receiving the dexmedetomidine infusion, the signs of the twitch-convulsive syndrome, particularly the twitching and tremors, disappeared. Within 30 minutes of the end of the dexmedetomidine infusion, symptoms of the twitch-convulsive syndrome returned, manifesting as acu... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5476038 Thu, 01 Dec 2011 05:00:00 +0100 5476038 http://www.medworm.com/index.php?rid=5476037&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS095281801100314X%2Fabstract%3Frss%3Dyes Abstract: A case of a newborn with a double-outlet right ventricle and tracheoesophageal fistula is presented. The pathophysiology of double-outlet right ventricle and its anesthetic implications for tracheoesophageal fistula repair are discussed. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5476037 Thu, 01 Dec 2011 05:00:00 +0100 5476037 http://www.medworm.com/index.php?rid=5476036&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003230%2Fabstract%3Frss%3Dyes Conclusion: Propofol sedation using BIS-guided TCI is a useful and safe method in the management of patients with intellectual disability. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5476036 Thu, 01 Dec 2011 05:00:00 +0100 5476036 http://www.medworm.com/index.php?rid=5476035&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003229%2Fabstract%3Frss%3Dyes Conclusions: The Ambu aScope, a single-use intubation scope, is a new addition to video laryngoscopy. The price should range within 10% of our intubation cost ($120.00 to $132.00 per single-use intubation scope). (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5476035 Thu, 01 Dec 2011 05:00:00 +0100 5476035 http://www.medworm.com/index.php?rid=5476034&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003217%2Fabstract%3Frss%3Dyes Conclusions: Ultrasound guidance for needle localization prior to catheter insertion for femoral nerve block results in similar block characteristics between stimulating and nonstimulating catheters. The use of nonstimulating catheters avoids the technical challenges of stimulating catheters and does not require additional helpers. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5476034 Thu, 01 Dec 2011 05:00:00 +0100 5476034 http://www.medworm.com/index.php?rid=5476033&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003205%2Fabstract%3Frss%3Dyes Conclusions: The key issue for anesthetic management of robot-assisted totally endoscopic ASD repair is maintaining stable hemodynamics and oxygenation, especially during one-lung ventilation and capnothorax. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5476033 Thu, 01 Dec 2011 05:00:00 +0100 5476033 http://www.medworm.com/index.php?rid=5476032&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS095281801100328X%2Fabstract%3Frss%3Dyes Conclusions: The LMA caused no change in Pd, HR, or MAP values during or after airway placement, but caused QTd after airway insertion. The ETT caused a sudden increase at the first minute after tube placement, without any Pd or QTd. In addition, DLT caused QTd without any serious change in hemodynamics. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5476032 Thu, 01 Dec 2011 05:00:00 +0100 5476032 http://www.medworm.com/index.php?rid=5476031&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003278%2Fabstract%3Frss%3Dyes Conclusion: Intravenous tranexamic acid effectively reduces bleeding and improves the surgical field during FESS. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5476031 Thu, 01 Dec 2011 05:00:00 +0100 5476031 http://www.medworm.com/index.php?rid=5476030&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003291%2Fabstract%3Frss%3Dyes Conclusions: With GlideScope-assisted tracheal intubation, Mallampati airway class is not an independent risk factor for difficult intubation. Other standard clinical risk factors of difficulty with direct laryngoscopy also do not appear to be individually predictive of first-attempt success of tracheal intubation. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5476030 Thu, 01 Dec 2011 05:00:00 +0100 5476030 http://www.medworm.com/index.php?rid=5476029&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003837%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5476029 Thu, 01 Dec 2011 05:00:00 +0100 5476029 http://www.medworm.com/index.php?rid=5476028&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003825%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5476028 Thu, 01 Dec 2011 05:00:00 +0100 5476028 http://www.medworm.com/index.php?rid=5384285&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002625%2Fabstract%3Frss%3Dyes This article has been retracted at the request of the Editor-in-Chief, Dr. Robert R. Gaiser, due to the author’s inability to provide either copies of Ethical Board approvals or BMI values for each patient. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384285 Tue, 01 Nov 2011 04:00:00 +0100 5384285 http://www.medworm.com/index.php?rid=5384284&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002984%2Fabstract%3Frss%3Dyes We report the use of thrombelastography (TEG) and Platelet Mapping Assay (Haemoscope Corp., Niles, IL, USA) in a patient with type 2A VWD (baseline values: FVIII: 24%; VWF:RCo test: 12%; VW antigen undetectable; absence of large VWF multimeric forms). (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384284 Tue, 01 Nov 2011 04:00:00 +0100 5384284 http://www.medworm.com/index.php?rid=5384283&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002996%2Fabstract%3Frss%3Dyes With limited mouth opening, tracheal intubation is made difficult. Masticatory muscle tendon-aponeurosis hyperplasia is a newly defined disease entity in which limited mouth opening results from limited masticatory muscle extension caused by hyperplasia of the tendon and aponeurosis. It is characterized by gradually progressive rigid limitation of mouth opening and a hard, tense, cord-like structure that comes in contact with the anterior margin of the masseter muscle during maximum mouth opening. Further, it is often accompanied by bilateral mandibular angle protrusion (square mandible configuration) . Two patients with masticatory muscle tendon-aponeurosis hyperplasia, in whom limited mouth opening was exacerbated after anesthesia induction, are presented. (Source: Journal of Clinical An... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384283 Tue, 01 Nov 2011 04:00:00 +0100 5384283 http://www.medworm.com/index.php?rid=5384282&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003011%2Fabstract%3Frss%3Dyes Spinal cord stimulation (SCS) has become an established modality in the treatment of chronic pain. The incidence of adverse events associated with SCS is high, but the rate of serious complications is low . The most common complications were hardware-related events such as lead displacement or fracturing. Biological complications included infection, hematoma, and cerebrospinal fluid (CSF) leak . A patient who developed urinary retention during trial of a spinal cord stimulator for lower back pain is presented. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384282 Tue, 01 Nov 2011 04:00:00 +0100 5384282 http://www.medworm.com/index.php?rid=5384281&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS095281801100300X%2Fabstract%3Frss%3Dyes We report a case in which LMA-S was easy to insert but difficult to place correctly in spite of the semi-sniffing position. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384281 Tue, 01 Nov 2011 04:00:00 +0100 5384281 http://www.medworm.com/index.php?rid=5384280&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002960%2Fabstract%3Frss%3Dyes Ryu and colleagues studied the impact of the remifentanil target concentration on patient satisfaction with their anesthetic for cataract surgery . They similarly compared satisfaction with three types of blocks . (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384280 Tue, 01 Nov 2011 04:00:00 +0100 5384280 http://www.medworm.com/index.php?rid=5384279&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002947%2Fabstract%3Frss%3Dyes Pulmonary alveolar proteinosis (PAP) is a rare respiratory disease. The estimated incidence and prevalence are 0.36 and 3.7 cases per million, respectively . Most of the patients with PAP are male and have a median age of 39 years at the time of diagnosis. The disease is characterized by accumulation of phospholipoproteinosis material in the alveoli. The accumulated material impairs gas exchange and results in hypoxemia. Congenital PAP presents with severe hypoxemia in the neonatal period, and accounts for 2% of cases . Secondary PAP accounts for 5%-10% of cases and is associated with hematopoietic malignancy or other underlying disease . Patients with PAP have progressive dyspnea of gradual onset with minimally productive cough, weight loss, easy fatigability, and cyanosis. Hemoptysis and... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384279 Tue, 01 Nov 2011 04:00:00 +0100 5384279 http://www.medworm.com/index.php?rid=5384278&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002923%2Fabstract%3Frss%3Dyes Patients who have developed a tolerance to opioid therapy are difficult to manage in the postsurgical period, especially in relation to postoperative analgesia. These patients often require substantially increased doses of opioids for treatment of their pain. Effective non-opioid analgesic agents such as dexmedetomidine, may be helpful in these situations. Alpha-2 adrenoceptor agonists such as clonidine and dexmedetomidine alleviate opioid withdrawal in the laboratory and in critically ill patients . There is increasing use of dexmedetomidine in parturients for sedation in the intensive care unit (ICU) , for awake fiberoptic intubations , and for intravenous analgesia . (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384278 Tue, 01 Nov 2011 04:00:00 +0100 5384278 http://www.medworm.com/index.php?rid=5384277&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002935%2Fabstract%3Frss%3Dyes The sugammadex molecule has been crafted to tightly and selectively bind rocuronium in the manner of a monovalent antibody . The complementarity is not absolute, as vecuronium is also bound effectively. Though the shape and dipolar features of the sugammadex “pocket” are important, the drug has another feature that contributes to its affinity for its ligands; each sugammadex molecule carries a net negative charge of -8 . Since rocuronium and vecuronium molecules each carry net positive charges of +2, polyvalent ionic bonds can contribute to the formation of complexes with sugammadex. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384277 Tue, 01 Nov 2011 04:00:00 +0100 5384277 http://www.medworm.com/index.php?rid=5384276&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002972%2Fabstract%3Frss%3Dyes Pain on intravenous injection of propofol is a common and well-studied problem. A systematic review involving 15 drugs and 12 physical treatments and their combinations identified several effective methods to decrease propofol injection pain, but none had a number-needed-to-treat better than NNT 1.6 . Few studies have specifically addressed preventing postoperative recall of propofol injection pain, with most reports of recall occurring in papers that concentrated on the prevention of pain during injection . We therefore conducted an audit to determine the incidence of postoperative recall of injection pain in adult patients receiving propofol for induction of anesthesia who reported it during injection. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384276 Tue, 01 Nov 2011 04:00:00 +0100 5384276 http://www.medworm.com/index.php?rid=5384275&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002686%2Fabstract%3Frss%3Dyes Subarachnoid-pleural fistulae have been reported as a consequence of trauma to the spine and, less frequently, as a complication of thoracotomy performed to remove a lung or paravertebral neoplasm . Assietti et al. reviewed 12 cases of subarachnoid-pleural fistula following thoracotomy and found various mechanisms of fistula production, ie, primary pathology in the upper lobe of the lung, tumors invading the chest wall in the costovertebral angle, particularly in those tumors invading the pedicle or the body of the vertebra, lesion of the dural sheath of a nerve root caused by a rib fracture at the level of the costovertebral junction during the retraction of the intercostal space, and intraoperative radiotherapy. D'Addario et al reported a case of pneumocephalus secondary to a tension pne... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384275 Tue, 01 Nov 2011 04:00:00 +0100 5384275 http://www.medworm.com/index.php?rid=5384274&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002674%2Fabstract%3Frss%3Dyes A 67 year old man with past medical history of type 2 diabetes, hypertension, deep venous thrombosis, ulcerative colitis, and abdominal cramps was admitted to our institution for evaluation of persistent chronic diarrhea. He was taking several prescribed medications, including prednisone, pioglitazone carvedilol, warfarin, and three anticholinergic-based medications (hyoscyamine, dicyclomine, and lomotil). As part of his gastrointestinal (GI) workup, he was scheduled for an elective esophagogastroduodenoscopy (EGD). The patient had fasted for more than 12 hours, except for a small amount of water taken with some of his medications, which were ingested three to 4 hours before the procedure. After appropriate sedation, the EGD probe was inserted into the patient's stomach. The procedural sta... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384274 Tue, 01 Nov 2011 04:00:00 +0100 5384274 http://www.medworm.com/index.php?rid=5384273&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002662%2Fabstract%3Frss%3Dyes With the patient in the prone position, the sagittal axis from incisor to oropharynx and the axis from oropharynx to hypopharynx are not in the same plane. Sometimes the tip of a Laryngeal Mask Airway (LM1A; LMA North America, Inc., San Diego, CA, USA) may deviate from the axis. A case of dislodgement of a right upper secondary premolar after insertion of a Classic LMA in a patient placed prone is presented. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384273 Tue, 01 Nov 2011 04:00:00 +0100 5384273 http://www.medworm.com/index.php?rid=5384272&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003163%2Fabstract%3Frss%3Dyes We appreciate the interest in our paper , as shown in the correspondence above. We believe, as Dr. Tyagi does, that “NSAIDs appear to represent no added significant risk for the development of spinal hematoma in patents having epidural or spinal anesthesia”, as stated in the practice guidelines . Therefore, we did not preclude neuraxial anesthesia because of the patient receiving aspirin. However, we did not perform neuraxial anesthesia in the first patient since he had a history of subdural hematoma, on the basis of the following description in the practice guidelines: “There is no wholly accepted test, including the bleeding time, which will guide antiplatelet therapy. Careful preoperative assessment of the patient to identify alterations of health that might contribute to bleeding... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384272 Tue, 01 Nov 2011 04:00:00 +0100 5384272 http://www.medworm.com/index.php?rid=5384271&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003175%2Fabstract%3Frss%3Dyes Discussion, the authors made certain misleading statements pertaining to the practice guidelines on management of regional anesthesia in patients receiving anticoagulants . (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384271 Tue, 01 Nov 2011 04:00:00 +0100 5384271 http://www.medworm.com/index.php?rid=5384270&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003151%2Fabstract%3Frss%3Dyes Abstract: There is rapidly increasing prevalence of obesity throughout Western societies and increasing numbers of patients undergoing surgery are obese. Obesity is a condition of chronic systemic inflammation and is associated with an increased burden of comorbidities. Despite traditional teaching, obesity may not be an independent risk factor for poor postoperative outcomes. The Obesity Paradox describes the observation that small amounts of excess body fat may be protective against postoperative complications. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384270 Tue, 01 Nov 2011 04:00:00 +0100 5384270 http://www.medworm.com/index.php?rid=5384269&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003138%2Fabstract%3Frss%3Dyes Abstract: Diaphragmatic herniation is known to create cardiorespiratory challenges for the anesthesiologist. With the increasing use of the transhiatal surgical approach for esophagectomy, the occurrence of transhiatal herniation of bowel is likely to be encountered. A case of circulatory collapse during induction of anesthesia in a patient with transhiatal herniation is presented. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384269 Tue, 01 Nov 2011 04:00:00 +0100 5384269 http://www.medworm.com/index.php?rid=5384268&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003126%2Fabstract%3Frss%3Dyes Abstract: Facemask ventilation has been associated with the development of postoperative nausea and vomiting, increasing the risk of tracheal aspiration; development of gastric distension that further impairs alveolar ventilation; perforation of gastric and duodenal ulcers; development of pneumothorax; extrabronchial air dissection; and development of cardiac dysrhythmias, including bradycardia from indirect vagal nerve stimulation. An unusual complication that occurred during prolonged facemask ventilation is presented: development of a pseudo-obstruction of the intrathoracic airway due to the presence of entrained esophageal air. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384268 Tue, 01 Nov 2011 04:00:00 +0100 5384268 http://www.medworm.com/index.php?rid=5384267&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003114%2Fabstract%3Frss%3Dyes Abstract: Epsilon-aminocaproic acid (EACA) is used frequently during surgery as prophylaxis to decrease blood loss and transfusion requirements. A rare complication of EACA induced acute hyperkalemia in a patient undergoing total hip replacement is presented. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384267 Tue, 01 Nov 2011 04:00:00 +0100 5384267 http://www.medworm.com/index.php?rid=5384266&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003102%2Fabstract%3Frss%3Dyes Abstract: A patient with endometrial cancer presented with intracranial hemorrhage from an undiagnosed metastatic brain tumor during abdominal radical hysterectomy. Since she was neurologically intact, a systematic examination for brain metastasis had not been performed preoperatively. After the surgery, she had delayed recovery from general anesthesia with right hemiplegia and aphasia. Computed tomography and magnetic resonance imaging showed left putaminal hemorrhage from brain metastasis. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384266 Tue, 01 Nov 2011 04:00:00 +0100 5384266 http://www.medworm.com/index.php?rid=5384265&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002613%2Fabstract%3Frss%3Dyes Abstract: Fibrodysplasia ossificans progressiva (FOP) is a rare disorder of the connective tissue leading to progressive tissue ossification and immobilization. Soft-tissue trauma may exacerbate this condition, causing further ossification. Multisystem involvement includes restrictive lung disease, cervical ankylosis with limited mouth opening, and cardiac dysfunction. A 39-year-old woman with FOP presented with multiple orthopedic spine and femur fractures sustained from a fall. Anesthetic management was complicated by airway, pulmonary, and positioning challenges. Neuromonitoring allowed identification of spinal cord ischemia while avoiding a wake-up test. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384265 Tue, 01 Nov 2011 04:00:00 +0100 5384265 http://www.medworm.com/index.php?rid=5384264&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003096%2Fabstract%3Frss%3Dyes Conclusions: Anesthesia care providers in recovery from addiction to anesthetic agents may undergo subsequent exposure to these agents due to medical necessity. Participation in a program of recovery with support from family members may decrease the risk of relapse but does not eliminate it. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384264 Tue, 01 Nov 2011 04:00:00 +0100 5384264 http://www.medworm.com/index.php?rid=5384263&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003084%2Fabstract%3Frss%3Dyes Conclusions: This experiment did not detect propofol in the blood of anesthesiologists who administered propofol-based IV sedation to patients. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384263 Tue, 01 Nov 2011 04:00:00 +0100 5384263 http://www.medworm.com/index.php?rid=5384262&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003072%2Fabstract%3Frss%3Dyes Conclusions: Although the three drugs are acceptable for obtaining an optimum surgical field, preoperative oral beta blocker appeared to be rapid in onset and was simpler to implement. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384262 Tue, 01 Nov 2011 04:00:00 +0100 5384262 http://www.medworm.com/index.php?rid=5384261&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002650%2Fabstract%3Frss%3Dyes Conclusions: The rapid administration of propofol reduces pain and facilitates LMA insertion versus slow administration of propofol. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384261 Tue, 01 Nov 2011 04:00:00 +0100 5384261 http://www.medworm.com/index.php?rid=5384259&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002637%2Fabstract%3Frss%3Dyes Conclusions: Menstrual phase has an effect on anatomical alterations (mechanical properties) in the hypotonic upper airway during propofol anesthesia. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384259 Tue, 01 Nov 2011 04:00:00 +0100 5384259 http://www.medworm.com/index.php?rid=5384258&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002546%2Fabstract%3Frss%3Dyes Conclusions: Epidural anesthesia for anterior lumbar interbody fusion is potentially beneficial compared with general anesthesia, showing improved perioperative pain control. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384258 Tue, 01 Nov 2011 04:00:00 +0100 5384258 http://www.medworm.com/index.php?rid=5384257&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011003461%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384257 Tue, 01 Nov 2011 04:00:00 +0100 5384257 http://www.medworm.com/index.php?rid=5384256&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS095281801100345X%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384256 Tue, 01 Nov 2011 04:00:00 +0100 5384256 http://www.medworm.com/index.php?rid=5384260&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002649%2Fabstract%3Frss%3Dyes Conclusion: The LMA-AIC-FOB technique is safe and effective for patients who are difficult to intubate after induction of anesthesia. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5384260 Thu, 13 Oct 2011 04:00:00 +0100 5384260 http://www.medworm.com/index.php?rid=5207722&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002601%2Fabstract%3Frss%3Dyes Abstract: Lung transplantation has become an accepted option for many patients with end-stage pulmonary diseases. Anesthesia and surgery following lung transplantation may be required for various diseases that may affect both systemic organs and the transplanted graft. When a patient with a lung transplant undergoes surgery, there is the potential for interference with lung function, depending on the type of intervention and its anatomical site. Accurate preoperative evaluation, an understanding of the physiology of the transplanted lung, proper airway instrumentation, individualized management of intraoperative ventilation, and fluid balance are essential for a positive perioperative outcome. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5207722 Thu, 01 Sep 2011 04:00:00 +0100 5207722 http://www.medworm.com/index.php?rid=5207721&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002583%2Fabstract%3Frss%3Dyes Abstract: Posterior reversible encephalopathy syndrome (PRES) is a rare disorder that is usually associated with hypertensive crises. It is often missed but may be diagnosed by head computed tomographic (CT) scan or magnetic resonance imaging. An adolescent man presented for elective right shoulder arthroscopic bankart repair. Arthroscopy was performed using a solution of normal saline with 3.3 mg/L of epinephrine for irrigation. Postoperatively, the patient presented with hypertension and epileptiform activity. A CT scan of the head showed PRES. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5207721 Thu, 01 Sep 2011 04:00:00 +0100 5207721 http://www.medworm.com/index.php?rid=5207720&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002571%2Fabstract%3Frss%3Dyes Abstract: Complex regional pain syndrome (CRPS) is a collection of signs and symptoms that most often include regional pain, edema, changes in skin temperature, increased skin sensitivity, and weakness that usually affects the extremities. It almost always exclusively affects the surgical site. A 52 year old woman presented with lower extremity CRPS due to positioning after a craniotomy. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5207720 Thu, 01 Sep 2011 04:00:00 +0100 5207720 http://www.medworm.com/index.php?rid=5207719&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS095281801100256X%2Fabstract%3Frss%3Dyes Abstract: Bispectral index monitoring (BIS) measures depth of anesthesia and sedation. The case of a neonatal patient who underwent surgical repair for a double aortic arch is presented. During surgery, BIS decreased to 0, and cerebral blood flow (CBF), as measured by transcranial doppler ultrasonography, could not be detected immediately after clamping of the arch. BIS returned to baseline, and CBF was detected only after the aortic arch was unclamped. The arch was then carefully reclamped during close BIS and CBF monitoring. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5207719 Thu, 01 Sep 2011 04:00:00 +0100 5207719 http://www.medworm.com/index.php?rid=5207718&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002595%2Fabstract%3Frss%3Dyes Abstract: A patient was scheduled for open infrarenal abdominal aortic aneurysm repair and the procedure was performed without complication. The pulmonary artery catheter (PAC) was unintentionally placed in the coronary sinus via an undiagnosed persistent left superior vena cava anomaly. Interpreting the waveform produced by the PAC in standard and abnormal locations such as the coronary sinus is equally as important as measuring and monitoring hemodynamic status. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5207718 Thu, 01 Sep 2011 04:00:00 +0100 5207718 http://www.medworm.com/index.php?rid=5207716&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002558%2Fabstract%3Frss%3Dyes Conclusions: Persistent pain after mastectomy and breast reconstruction has a high prevalence (43%). Genetic mutations may contribute to the development of persistent pain following surgery; however, larger studies are required for confirmation. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5207716 Thu, 01 Sep 2011 04:00:00 +0100 5207716 http://www.medworm.com/index.php?rid=5207715&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002522%2Fabstract%3Frss%3Dyes Conclusion: The EzT has distinct advantages over the ETC in airway management, including shorter time to achieve an effective airway and easier insertion. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5207715 Thu, 01 Sep 2011 04:00:00 +0100 5207715 http://www.medworm.com/index.php?rid=5207714&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002510%2Fabstract%3Frss%3Dyes Conclusions: A structured transfusion medicine curriculum improved anesthesiology resident knowledge in transfusion medicine and was associated with high learner satisfaction. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5207714 Thu, 01 Sep 2011 04:00:00 +0100 5207714 http://www.medworm.com/index.php?rid=5207713&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002509%2Fabstract%3Frss%3Dyes Conclusion: The frequency of PONV was reduced significantly with both antiemetic combinations. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5207713 Thu, 01 Sep 2011 04:00:00 +0100 5207713 http://www.medworm.com/index.php?rid=5207712&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002492%2Fabstract%3Frss%3Dyes Conclusions: The SLMA is easy to insert and it is an effective ventilatory device for laparoscopic cholecystectomy. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5207712 Thu, 01 Sep 2011 04:00:00 +0100 5207712 http://www.medworm.com/index.php?rid=5207711&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002480%2Fabstract%3Frss%3Dyes Conclusions: The off-pump approach does not protect against AF, and nonlinear HRV analyses provide little value in predicting AF after off-pump CABG. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5207711 Thu, 01 Sep 2011 04:00:00 +0100 5207711 http://www.medworm.com/index.php?rid=5207707&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002728%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5207707 Thu, 01 Sep 2011 04:00:00 +0100 5207707 http://www.medworm.com/index.php?rid=5207706&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002716%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5207706 Thu, 01 Sep 2011 04:00:00 +0100 5207706 http://www.medworm.com/index.php?rid=5207709&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002479%2Fabstract%3Frss%3Dyes Conclusions: Deep sedation without intubation is a viable method of anesthesia for both first and second-trimester surgical abortions in the outpatient setting. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5207709 Wed, 10 Aug 2011 04:00:00 +0100 5207709 http://www.medworm.com/index.php?rid=5207708&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002467%2Fabstract%3Frss%3Dyes The subject of aspiration in obstetrics patients has been widely discussed since the 1940s, when Mendelson published the first retrospective study addressing the issue . The Closed Claims Analysis on Obstetric Anesthesia from 2009 confirms the continued risk of aspiration in maternal morbidity and mortality . Pregnancy may independently increase the risk of aspiration by increasing intragastric pressures and altering the anatomic relationship between the esophagus, diaphragm, and stomach . Furthermore, increases in progesterone levels have been implicated in decreasing lower esophageal sphincter tone . While these changes clearly impact aspiration risk, the precise timing on when these changes become clinically significant (ie, placing the parturient at higher risk for aspiration) during t... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5207708 Wed, 10 Aug 2011 04:00:00 +0100 5207708 http://www.medworm.com/index.php?rid=5078467&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002194%2Fabstract%3Frss%3Dyes The year of Dr. Meyer Saklad's death was 1979, not 1970, as reported. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5078467 Sat, 30 Jul 2011 14:51:20 +0100 5078467 http://www.medworm.com/index.php?rid=5078466&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002182%2Fabstract%3Frss%3Dyes All but one co-author (Jeremy W. Goldfarb, MD) are affiliated with Massachusetts General Hospital. Edward A. Bittner, MD, PhD (Staff Anesthesiologist), Edward George, MD, PhD (Assistant Professor of Anaesthesia), Charles Welch, MD (Associate Professor of Psychiatry), and Ulrich Schmidt, MD, PhD (Assistant Professor of Anaesthesia) are all on staff at Massachusetts General Hospital. Dr. Goldfarb, who was a Fellow in Anesthesia and Critical Care at MGH at the time the manuscript was submitted, is now Staff Anesthesiologist at Massachusetts Eye and Ear Infirmary. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5078466 Sat, 30 Jul 2011 14:51:20 +0100 5078466 http://www.medworm.com/index.php?rid=5078464&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002133%2Fabstract%3Frss%3Dyes We describe a scenario in which a sharp knife in the esophagus was retrieved successfully using a flexible esophagoscope and Magill forceps. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5078464 Sat, 30 Jul 2011 14:51:19 +0100 5078464 http://www.medworm.com/index.php?rid=5078453&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002029%2Fabstract%3Frss%3Dyes Conclusions: The addition of clonidine 0.5 μg/kg to the local anesthetics of a retrobulbar block for vitreoretinal surgery decreases the frequency of postoperative pain and prolongs the time of analgesia. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5078453 Sat, 30 Jul 2011 14:51:17 +0100 5078453 http://www.medworm.com/index.php?rid=5078452&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002017%2Fabstract%3Frss%3Dyes Conclusions: Intraoperative hypotension, but not tachycardia, was observed in three of 13 patients with POTS who received general anesthesia for a variety of surgical procedures using multiple medications and techniques. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5078452 Sat, 30 Jul 2011 14:51:16 +0100 5078452 http://www.medworm.com/index.php?rid=5078450&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001991%2Fabstract%3Frss%3Dyes Conclusion: The frequency of anxious patients is variable at different time points before surgery. The factors correlating with anxiety before surgery are nonmodifiable. Providing information to those individuals is the only modifiable option. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5078450 Sat, 30 Jul 2011 14:51:16 +0100 5078450 http://www.medworm.com/index.php?rid=5078446&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002200%2Fabstract%3Frss%3Dyes I recently caught a rerun of one of my favorite episodes of Scrubs. It introduces Nephrologist Dr. Doug Townshend (expertly played by Dick Van Dyke) to Sacred Heart Hospital as best friend and antithesis of Chief of Medicine Dr. Bob Kelso. After an outdated technique leads to a poor outcome, Dr. Kelso confronts his friend about his obsolete treatment regimens, to which Dr. Townshend responds simply, “Come on, Bob… guys like us, we're set in our ways.” Once Dr. Kelso expounds on how he “[spends] every other weekend at a seminar in some two-star hotel ballroom… because [he has] to keep up,” his friend admits that he doesn't have the energy to do that anymore . (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5078446 Sat, 30 Jul 2011 14:51:14 +0100 5078446 http://www.medworm.com/index.php?rid=5078445&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002248%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5078445 Sat, 30 Jul 2011 14:51:14 +0100 5078445 http://www.medworm.com/index.php?rid=5078444&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002236%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5078444 Sat, 30 Jul 2011 14:51:14 +0100 5078444 http://www.medworm.com/index.php?rid=5207725&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002157%2Fabstract%3Frss%3Dyes When intubating the tracheas of patients with gastrointestinal bleeding, vomiting, or copious secretions, standard suction often is inadequate to provide good intubating conditions. As soon as the suction catheter is removed and the endotracheal tube (ETT) is picked up, the liquid reaccumulates, preventing visualization of the airway structures. In these situations, we attach a neonatal meconium aspirator (Neotech Products, Inc., Valencia, CA, USA) to the end of the ETT, then connect the ETT to suction (). By occluding the suction-activation hole with a finger tip, the ETT becomes a large-bore suction catheter. This action allows for continuous removal of the blood/secretions throughout ETT placement and provides a clear view of the glottic structures; the patient’s trachea then is intub... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5207725 Mon, 25 Jul 2011 04:00:00 +0100 5207725 http://www.medworm.com/index.php?rid=5207723&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002169%2Fabstract%3Frss%3Dyes A 5 month old male infant presented for laparoscopic fundoplication. General anesthesia was induced via inhalation of sevoflurane 8% in oxygen. Intravenous access was obtained after induction. Blankets supporting the patient's shoulders and a foam pad under the patient's head were used to optimize airway manipulation. Easy mask ventilation was established before neuromuscular relaxation. Three laryngoscopies were performed and a Cormack-Lehane grade 2 view was obtained during all attempts. When a regularly styletted endotracheal tube (ETT; size 4.0 cuffed; Mallinckrodt, Athlone, Ireland) was introduced through the oral cavity, the small mouth opening partly or entirely obscured the laryngoscopic views. In addition, the proximal part of the ETT touched the upper lip at all times, limiting f... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5207723 Mon, 25 Jul 2011 04:00:00 +0100 5207723 http://www.medworm.com/index.php?rid=5207724&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002170%2Fabstract%3Frss%3Dyes Traditional measures of operating room (OR) efficiency include staffing costs, start-time tardiness, case cancellation rate, Postanesthesia Care Unit admission delays, contribution margin, turnover times, prediction bias, and amount of underutilized and overutilized hours of OR time . According to macroeconomic theory, efficiency may be defined as the use of scarce resources to achieve all opportunities in production (output) . Operating room efficiency also may be defined as the allocation of limited resources (labor, time, space, equipment) to maximize OR use. Efficiency also implies a tradeoff between the quantity of one good produced relative to the quantity of one or more other goods produced; there is no way to produce more of one good without producing less of the other goods . (Sou... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5207724 Fri, 22 Jul 2011 04:00:00 +0100 5207724 http://www.medworm.com/index.php?rid=5207710&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002030%2Fabstract%3Frss%3Dyes Conclusions: The lamina technique for placement of a paravertebral catheter is a feasible and effective technique for intraoperative and postoperative analgesia in patients scheduled for major breast surgery with or without axillary lymph node resection. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5207710 Wed, 13 Jul 2011 04:00:00 +0100 5207710 http://www.medworm.com/index.php?rid=5078465&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002145%2Fabstract%3Frss%3Dyes Venous air embolism (VAE) is a frequent complication in sitting position procedures . Its prevention and early detection are crucial to avoid potentially hazardous consequences. A case in which the first warning sign of air embolism was an unexpected increase in regional cerebral oxygen saturation (rSO2) is presented. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5078465 Sun, 10 Jul 2011 23:00:00 +0100 5078465 http://www.medworm.com/index.php?rid=5078460&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002121%2Fabstract%3Frss%3Dyes Abstract: von Willebrand disease (VWD) is the most common hereditary bleeding disorder in humans, with an estimated prevalence of 0.5% to 1%. Patients with VWD are at increased risk of perioperative bleeding complications. This review provides an evidence-based overview of VWD and its management during the perioperative period. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5078460 Sun, 10 Jul 2011 23:00:00 +0100 5078460 http://www.medworm.com/index.php?rid=5078459&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002091%2Fabstract%3Frss%3Dyes Abstract: Sheehan's syndrome is a well described entity that refers to hypopituitarism with pituitary infarction secondary to postpartum shock or hemorrhage. Antepartum pituitary infarction is a very rare condition that has been reported only in patients with longstanding type 1 diabetes mellitus or uncontrolled gestational diabetes. A case of severe, acute hypopituitarism in the setting of hemorrhagic shock from a gunshot wound is presented. Our case report highlights the importance of including hypopituitarism in the differential diagnosis of a critically ill parturient. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5078459 Sun, 10 Jul 2011 23:00:00 +0100 5078459 http://www.medworm.com/index.php?rid=5078457&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS095281801100208X%2Fabstract%3Frss%3Dyes Abstract: A 37 year old woman with Marfan's syndrome underwent an elective gynecologic procedure. Mask ventilation was not difficult but initial direct laryngoscopy showed no view of the glottic opening. The patient's trachea was quickly and successfully intubated using a supraglottic jet ventilation technique. The technique provided oxygenation and ventilation during intubation and assisted intubation of a patient with a grade III glottic view. No hypoxia or barotrauma were noted during the intubation. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5078457 Sun, 10 Jul 2011 23:00:00 +0100 5078457 http://www.medworm.com/index.php?rid=5078455&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002042%2Fabstract%3Frss%3Dyes We present a patient who suffered an intraoperative fulminant intracardiac and aortic thrombosis and posthumously was found to have had high anticardiolipin immunoglobulin M concentration and markers of hyperfibrinolysis in preoperatively collected plasma. Hemostatic therapy in the presence of circulating antiphospholipid antibodies and the pathogenesis of a catastrophic antiphospholipid syndrome are discussed. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5078455 Sun, 10 Jul 2011 23:00:00 +0100 5078455 http://www.medworm.com/index.php?rid=5078451&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002005%2Fabstract%3Frss%3Dyes Conclusion: A remifentanil effect-site concentration of 2.16 ± 0.19 ng/mL given before a propofol effect-site concentration of 4 μg/mL allowed lightwand intubation without muscle relaxant. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5078451 Sun, 10 Jul 2011 23:00:00 +0100 5078451 http://www.medworm.com/index.php?rid=5078458&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS095281801100211X%2Fabstract%3Frss%3Dyes Abstract: Repair of a retinal detachment was performed during a retrobulbar block with monitored anesthesia care and intravenous conscious sedation. Following the procedure and after removal of the sterile drapes, the patient exhibited significant swelling of the bilateral orbits, face, neck, and chest. Subcutaneous emphysema and pneumomediastinum were confirmed on postoperative chest radiographs and computed tomographic scans. Possible mechanisms and potential sequelae of this intraoperative event are discussed. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5078458 Sun, 03 Jul 2011 23:00:00 +0100 5078458 http://www.medworm.com/index.php?rid=5078456&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002054%2Fabstract%3Frss%3Dyes Abstract: Difficult endotracheal intubation is a clinical challenge for anesthesiologists and other practitioners of airway management. The use of a tracheoscopic ventilation tube, a novel airway device, for endotracheal intubation during general anesthesia in two patients with difficult airways after unsuccessful direct laryngoscopy is presented. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5078456 Sun, 03 Jul 2011 23:00:00 +0100 5078456 http://www.medworm.com/index.php?rid=5207717&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011002108%2Fabstract%3Frss%3Dyes Abstract: A potentially life-threatening arrhythmia appeared on the preinduction electrocardiogram of an asymptomatic young woman prior to spine surgery. The patient was evaluated by electrophysiology and had a rare accessory pathway, a Mahaim Fiber. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5207717 Wed, 29 Jun 2011 04:00:00 +0100 5207717 http://www.medworm.com/index.php?rid=5637930&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001772%2Fabstract%3Frss%3Dyes Conclusions: The combination of nicardipine 20 μg/kg and esmolol 0.5 mg/kg most effectively attenuates the cardiovascular responses during rapid-sequence induction. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5637930 Thu, 23 Jun 2011 04:00:00 +0100 5637930 http://www.medworm.com/index.php?rid=5078447&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001760%2Fabstract%3Frss%3Dyes Conclusions: Protocols for ADP management are rare. There is wide variation in catheter management after dural puncture, measures used to prevent and treat a resultant headache, and EBP management. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5078447 Wed, 22 Jun 2011 23:00:00 +0100 5078447 http://www.medworm.com/index.php?rid=5078463&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001759%2Fabstract%3Frss%3Dyes A patient developed atrial fibrillation (AF) with rapid ventricular response after initiation of veno-venous bypass (VVBP). The arrhythmia was refractory to pharmacologic intervention and resolved only with termination of bypass. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5078463 Wed, 15 Jun 2011 23:00:00 +0100 5078463 http://www.medworm.com/index.php?rid=5078449&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001310%2Fabstract%3Frss%3Dyes Conclusions: Early detection and prompt correction of inappropriate ETT positioning after intubation prevented further ETT migration into undesired positions. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5078449 Sun, 05 Jun 2011 23:00:00 +0100 5078449 http://www.medworm.com/index.php?rid=5078462&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001693%2Fabstract%3Frss%3Dyes Although “pain” is regarded as the sine qua non of complex regional pain syndrome (CRPS), reports of painless CRPS do exist . A 50 year old woman sustained fractures at her left elbow and wrist, which were surgically fixed and immobilized with a cast for 45 days. Subsequently she developed rigidity with difficulty in extension. A referral to physiotherapy was made by the surgeon, who did not explain the diagnosis of CRPS to the patient. She noticed other changes, including swelling of her hand, increased hair growth, fingers turning blue, increased sweating, and increased rigidity. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5078462 Tue, 31 May 2011 23:00:00 +0100 5078462 http://www.medworm.com/index.php?rid=5078461&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS095281801100167X%2Fabstract%3Frss%3Dyes Use of the GlideScope video laryngoscope (Verathon, Bothell, WA, USA) has increased endotracheal intubation success rates, reduced the time required to perform tracheal intubation, reduced the need for additional maneuvers, and reduced the potential for dental trauma . The GlideScope has been proven to be useful both as a primary and a rescue device for difficult airway management in different patient populations: adult , pediatric , infant , and parturient . (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5078461 Tue, 31 May 2011 23:00:00 +0100 5078461 http://www.medworm.com/index.php?rid=5078448&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001346%2Fabstract%3Frss%3Dyes Conclusion: Bradycardia after spinal anesthesia occurs commonly. Prophylactic glycopyrrolate may prevent the bradycardia, but not necessarily the hypotension. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=5078448 Tue, 31 May 2011 23:00:00 +0100 5078448 http://www.medworm.com/index.php?rid=4913059&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001681%2Fabstract%3Frss%3Dyes In obese patients, hypoxemia during induction of general anesthesia increases with body mass index (BMI) due to a decrease in functional residual capacity and an increase in oxygen consumption. Preoxygenation with positive pressure (10 cm H2O) is recommended in these patients . Furthermore, in 13% to 20% of cases of morbid obesity, tracheal intubation is difficult , requiring a fiberoptic laryngoscope (fiberscope). The Boussignac valve (Vygon Medical, Montgomeryville, PA, USA) allows for maintenance of continuous positive airway pressure during the entire fiberoptic tracheal intubation procedure. Our study prospectively assessed the feasibility of such intubation through a Boussignac valve in patients with a BMI greater than 40 kg/m2. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=4913059 Tue, 31 May 2011 23:00:00 +0100 4913059 http://www.medworm.com/index.php?rid=4913058&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001668%2Fabstract%3Frss%3Dyes We describe a case of laceration of the palatine tonsil caused by the pediatric Airtraq during elective intubation. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=4913058 Tue, 31 May 2011 23:00:00 +0100 4913058 http://www.medworm.com/index.php?rid=4913057&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001309%2Fabstract%3Frss%3Dyes Use of the Aintree Intubation Catheter (AIC; Cook Medical, Bloomington, IN, USA) as an airway exchange catheter to facilitate intubation through the Laryngeal Mask Airway has been reported . A case of an iatrogenic tracheal foreign body resulting from a broken AIC during tracheal intubation via a classical Laryngeal Mask Airway (cLMA) is presented. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=4913057 Tue, 31 May 2011 23:00:00 +0100 4913057 http://www.medworm.com/index.php?rid=4913055&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001656%2Fabstract%3Frss%3Dyes Abstract: Carcinoid tumors are uncommon, slow-growing neoplasms. These tumors are capable of secreting numerous bioactive substances, which results in significant potential challenges in the management of patients afflicted with carcinoid syndrome. Over the past two decades, both surgical and medical therapeutic options have broadened, resulting in improved outcomes. The pathophysiology, clinical signs and symptoms, diagnosis, treatment options, and perioperative management, including anesthetic considerations, of carcinoid syndrome are presented. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=4913055 Tue, 31 May 2011 23:00:00 +0100 4913055 http://www.medworm.com/index.php?rid=4913054&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001437%2Fabstract%3Frss%3Dyes Abstract: A case of hand ischemia associated with use of an axillary arterial catheter in a multi-trauma patient is presented. Despite removal of the arterial catheter and limb salvage procedures, distal hand gangrene developed. Simple measures such as minimizing dressings, use of distal continuous pulse oximetry, placement of invasive arterial catheters in the nondominant extremity, and avoiding their use whenever possible may prevent complications and minimize morbidity. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=4913054 Tue, 31 May 2011 23:00:00 +0100 4913054 http://www.medworm.com/index.php?rid=4913053&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001425%2Fabstract%3Frss%3Dyes We report the case of a 13 year old patient who received 3.0 mg of remifentanil during a 50-minute surgical procedure as a result of a dosage miscalculation. The patient failed to awaken at the conclusion of the procedure and showed signs of opioid overdose. She recovered spontaneously two hours later. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=4913053 Tue, 31 May 2011 23:00:00 +0100 4913053 http://www.medworm.com/index.php?rid=4913052&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001413%2Fabstract%3Frss%3Dyes We present a case of face transplantation from a donor who had suffered a severe stroke, possibly from HIT, during cardiac surgery. The procedure was planned to include full heparinization. The anesthesia team was involved in the early planning phase and had detailed access to the donor's medical history; alternative anticoagulation for the donor and recipient was suggested so as to avoid a possible complication. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=4913052 Tue, 31 May 2011 23:00:00 +0100 4913052 http://www.medworm.com/index.php?rid=4913051&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001401%2Fabstract%3Frss%3Dyes Abstract: Two patients with spinocerebellar ataxia received epidural analgesia with no exacerbation of their symptoms. The patients developed transient, but extremely severe, low back pain as a result of the epidural analgesia. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=4913051 Tue, 31 May 2011 23:00:00 +0100 4913051 http://www.medworm.com/index.php?rid=4913050&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001395%2Fabstract%3Frss%3Dyes Abstract: A 52 year old woman who suffered a cardiac arrest was treated in a local hospital with cardiopulmonary resuscitation. Following transfer to our hospital, she developed renal failure, hypertension, impaired consciousness, headache, and visual disturbances. Magnetic resonance imaging (MRI) showed high signal intensity areas in the periventricular deep cerebral white matter and subcortical white matter (mainly in the parieto-temporo-occipital lobes), findings typical of posterior reversible encephalopathy syndrome. After the MRI findings, her nitroglycerin infusion was stopped, and antihypertensive therapy was initiated using beta blockers and alpha-agonists. She was also treated with continuous venovenous hemofiltration. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=4913050 Tue, 31 May 2011 23:00:00 +0100 4913050 http://www.medworm.com/index.php?rid=4913049&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001383%2Fabstract%3Frss%3Dyes Abstract: General and neuraxial anesthesia in patients with increased intracranial pressure (ICP) who present for non-neurosurgical surgery may cause life-threatening changes in ICP, with possible fatal outcome. Peripheral nerve blocks may be a safe alternative technique for limb surgery. The successful use of psoas compartment block for operative reduction of a hip fracture in a patient with increased ICP due to an inoperable brain tumor is presented. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=4913049 Tue, 31 May 2011 23:00:00 +0100 4913049 http://www.medworm.com/index.php?rid=4913048&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001371%2Fabstract%3Frss%3Dyes Abstract: The ultrasound-guided transversus abdominis plane (TAP) block is a useful tool in controlling postoperative pain following abdominal surgery. The bilateral ultrasound-guided TAP blocks successfully managed the pain of a patient presenting with hypoxemia and respiratory failure in the Post-anesthesia Care Unit, following a laparotomy for small bowel obstruction during general anesthesia. The TAP block reduced systemic opioid requirements and opioid-induced sedation and respiratory depression, improved patient compliance with non-invasive positive pressure ventilation, and prevented the need for intubation and ventilation in the intensive care unit. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=4913048 Tue, 31 May 2011 23:00:00 +0100 4913048 http://www.medworm.com/index.php?rid=4913047&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001322%2Fabstract%3Frss%3Dyes Conclusion: Homozygous and heterozygous carrier status for the major SNP, rs10494366 allele (T), in intron 1 of the human NOSA1P gene may be associated with an increased risk of QTc interval prolongation following administration of 5-HT3-receptor antagonists in the perioperative setting, when compared with homozygotes for the minor (G) allele. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=4913047 Tue, 31 May 2011 23:00:00 +0100 4913047 http://www.medworm.com/index.php?rid=4913046&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001292%2Fabstract%3Frss%3Dyes Conclusions: IV landiolol reduces the MAC of sevoflurane in women by approximately 20%. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=4913046 Tue, 31 May 2011 23:00:00 +0100 4913046 http://www.medworm.com/index.php?rid=4913045&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001334%2Fabstract%3Frss%3Dyes Conclusions: For the insertion or removal of long-term central venous access devices, all three remifentanil infusion rates proved to be equally analgesic-efficient. However, the excessive sedation and tendency to respiratory and cardiovascular events associated with the highest remifentanil infusion rate renders such a rate less desirable for this purpose. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=4913045 Tue, 31 May 2011 23:00:00 +0100 4913045 http://www.medworm.com/index.php?rid=4913044&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001280%2Fabstract%3Frss%3Dyes Conclusion: The Airtraq and GlideScope facilitated nasotracheal intubation more so than the Macintosh laryngoscope in adults with apparently normal airways. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=4913044 Tue, 31 May 2011 23:00:00 +0100 4913044 http://www.medworm.com/index.php?rid=4913043&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001279%2Fabstract%3Frss%3Dyes Conclusions: The majority of anesthesiology training programs accredited by the Accreditation Council for Graduate Medical Education provide some form of skill-based instruction in surgical airway management for their residents. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=4913043 Tue, 31 May 2011 23:00:00 +0100 4913043 http://www.medworm.com/index.php?rid=4913042&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001267%2Fabstract%3Frss%3Dyes Conclusions: Intravenous pretreatment with methylene blue appears to be effective in reducing the pain during propofol injection. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=4913042 Tue, 31 May 2011 23:00:00 +0100 4913042 http://www.medworm.com/index.php?rid=4913039&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS095281801100136X%2Fabstract%3Frss%3Dyes I don't care too much for money, money can't buy me love.—John Lennon and Paul McCartney, 1964 I remember meeting this rather nice girl and taking her out for dinner in this MG in the cool Florida night, palm trees swaying. You kidding? A Liverpool boy with this tanned beauty in my MG going out to dinner. It should have been “Can Buy Me Love,” actually.—Paul McCartney, 1997 (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=4913039 Tue, 31 May 2011 23:00:00 +0100 4913039 http://www.medworm.com/index.php?rid=4913038&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001814%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=4913038 Tue, 31 May 2011 23:00:00 +0100 4913038 http://www.medworm.com/index.php?rid=4913037&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001802%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=4913037 Tue, 31 May 2011 23:00:00 +0100 4913037 http://www.medworm.com/index.php?rid=4913040&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001243%2Fabstract%3Frss%3Dyes Conclusions: The Mayo Clinic Scholar program effectively recruited ACCM fellows and faculty in a single institution. Incentive-based programs should be considered to support the involvement of anesthesiologists in perioperative medicine. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=4913040 Sun, 15 May 2011 23:00:00 +0100 4913040 http://www.medworm.com/index.php?rid=4821524&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS095281801100122X%2Fabstract%3Frss%3Dyes We recently were requested to anesthetize a two year old girl with Golz syndrome. She presented to us for a cystoscopy and vaginoscopy secondary to a covered bladder extropy. Golz syndrome is a rare, X-linked genetic disorder that has been implicated in mutations on the PORCN gene locus Xp-11.2.3. This syndrome is also referred to as focal dermal hypoplasia, which is one of the main characteristics of the syndrome. The skin lesions are characterized as linear, reticulated, and symmetrical tender red or pink macules that follow the lines of Blaschko. These lesions may have ulcerations secondary to lack of the dermis and telangiectasias. Other features commonly seen are nail atrophy with nail spooning and grooves, asymmetry of the face, with a pointed chin, and low set asymmetry of the ears... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=4821524 Sat, 30 Apr 2011 23:00:00 +0100 4821524 http://www.medworm.com/index.php?rid=4821523&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001218%2Fabstract%3Frss%3Dyes An 85 year old man taking aspirin-dipyridamole 25-200 mg extended-release capsule (Aggrenox ERC; Boehringer Ingelheim Pharmaceuticals Inc., Ingelheim, Germany) presented for transurethral resection of bladder carcinoma. Concern for intraoperative bleeding led to a request for Thrombelastrograph platelet mapping (TEGR-PM; Haemoscope, Skokie, IL, USA) to assess platelet inhibition. TEGR-PM evaluates platelet inhibition from both aspirin, in response to arachidonic acid (AA) stimulation, and clopidogrel, in response to adenosine diphosphate (ADP) stimulation . Consent was not taken as testing was requested as a prerequisite to surgery. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=4821523 Sat, 30 Apr 2011 23:00:00 +0100 4821523 http://www.medworm.com/index.php?rid=4821522&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001255%2Fabstract%3Frss%3Dyes A 47 year old, 180 cm, 75 kg man with an unremarkable past medical history was referred to the orthopedics department for a painful left knee. Preoperative imaging studies suggested a benign lesion. A chondroid tumor was suspected. The patient was scheduled for excision biopsy of the femur mass and cryoablation. Cryosurgery of benign and low-grade malignant bone tumors is a well established therapeutic procedure in orthopedic oncology . (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=4821522 Sat, 30 Apr 2011 23:00:00 +0100 4821522 http://www.medworm.com/index.php?rid=4821521&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818011001206%2Fabstract%3Frss%3Dyes We sincerely appreciate Dr. Xue and colleagues’ interest in our correspondence and thank them for their comments. They suggested that when the Parker endotracheal tube (ETT; Parker Medical, Highlands Ranch, CO, USA) is used for tracheal intubation with the Airway Scope (AWS; Pentax Hoya, Tokyo, Japan), inserting the AWS Pblade into the epiglottic vallecula via a Macintosh-type approach may be suitable as there is some space between the AWS PBlade tip and the Parker ETT. This space with the AWS also appears with a straight (siliconized) ETT when this ETT is advanced into a posterior portion of the larynx. Similar to a straight ETT, the Parker ETT with a Miller-type approach seems to advance into a posterior portion of the larynx. However, the Parker ETT is not a siliconized ETT; it is a c... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=4821521 Sat, 30 Apr 2011 23:00:00 +0100 4821521 http://www.medworm.com/index.php?rid=4821520&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS095281801100119X%2Fabstract%3Frss%3Dyes The recent correspondence of Kitagawa et al. , regarding the combined use of the Airway Scope (AWS; Pentax Hoya, Tokyo, Japan) and Parker Flex-Tip tube (Parker tube; Parker Medical, Highlands Ranch, CO, USA) to facilitate smooth passage of the endotracheal tube (ETT) through the glottis, was of great interest to us. We completely agree that when the AWS PBlade tip is correctly placed behind the epiglottis, difficulty in advancing the ETT may occasionally occur, as the ETT tip collides with the arytenoids. However, we have a concern about the use of a Parker tube to solve this issue, even though Kitagawa successfully completed the tracheal intubation by this method in their case. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=4821520 Sat, 30 Apr 2011 23:00:00 +0100 4821520