[A severe complication of peridural trimecaine anesthesia].
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Because small hospitals tend to have few members on their anesthesia services, perform less complicated and less extensive surgical procedures, use relatively straightforward anesthesia regimes, and have low anesthesia complication rates, foci for review may be difficult to identify. A review of intraoperative and postoperative mortality can be a productive approach, however. The authors provide criteria to help small hospitals identify problem areas in the delivery of anesthesia care through mortality review.
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Trismus may be a complication from local anesthesia. Patients with trismus of unknown cause after dental treatment should be evaluated thoroughly. The dentist should perform a complete examination and establish a differential diagnosis to avoid missing a serious or life-threatening infection. A right lateral pharyngeal space infection developed after a general restorative procedure that involved an inferior alveolar nerve injection on the same side. The patient's severe trismus required awake intubation, incision and drainage while the patient was under general anesthesia, treatment with antibiotics and ten days of hospitalization.
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Epidural hematoma is a rare complication of epidural anesthesia, but once this severe complication has occurred, without early decompressive procedure, it may cause permanent neurologic disorder. Especially, the patients with hemostatic disorder have a higher risk of epidural hematomas. We report a patient who recovered immediately from neurological symptoms resulting from epidural hematoma formed by epidural catheterization on the day before coronary artery bypass. Epidural hematoma as a complication of epidural anesthesia is discussed.
The aim of the investigation is to evaluate the dependence of the most frequent postextraction complications (pain, hemorrhage, hematoma, swelling and dry socket) in relation to the choice of anesthesia. The total of 447 teeth was extracted in 319 male and female persons between 11 and 80 years of age. The most important conclusion of the investigations is that vasoconstrictor in local anesthetic solutions does not influence the incidence of postextraction complications. Clot disturbance, higher incidence of dry socket and unpredicted time of pain appearance were found in the local anesthetic group with lower concentration of vasoconstrictor. Statistically significant difference between local and general anesthesia does not exist in relation to blood clot disturbances, although a great number of clot fails is evident in local anesthetic group. The pain intensity is lower when teeth extraction were performed under general anesthesia.
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Postoperative nausea and vomiting frequently complicate outpatient anesthesia and surgery. The duration of treatment for this complication must occasionally extend beyond discharge from the hospital. In this study, we evaluated the commonly used anti-emetic promethazine for its efficacy in the post-discharge period. Adult outpatient surgical patients who had excessive postoperative nausea and vomiting in the recovery room, or who were at risk for postoperative nausea and vomiting following discharge were given two promethazine suppositories (25 mg) for home use. All patients were contacted by our recovery room nurses on the first business day after their surgery and questioned as to their use of the suppositories and, if used, their efficacy. We found that 55 percent of patients given promethazine suppositories for home use had nausea and vomiting in the post-discharge period. Of the patients given promethazine, 89 percent used the suppositories. All of these patients reported improvement in their symptoms following use of the suppositories. None reported adverse effects from the promethazine suppositories. In conclusion, we found promethazine suppositories to be an inexpensive and efficacious treatment for nausea and vomiting in adult outpatient surgical patients following discharge from the hospital. Side-effects were minimal, and our patients voiced no complaints about this mode of therapy. We recommend this therapy for treatment of nausea and vomiting after hospital discharge following adult outpatient surgery.
(1) The present status of acupuncture anesthesia for cesarean section in China was presented. (2) Data were divided into two groups by the period, one group containing 24271 cases from 1975 to 1980 in 18 provinces and the other containing 16649 cases from 1981 to 1987 in 5 provinces. The successful rates were 92.1% and 98.9%, and the combined rates of excellent and good degrees were 74.5% and 87.1% in the former and the latter group, respectively. Thus, the effectiveness was significantly elevated in the latter group. (3) Physiological parameters under acupuncture anesthesia were compared with those under epidural anesthesia and local anesthesia. In acupuncture anesthesia, blood pressure, pulse rate and respiration were stable during operation, and blood loss was less than in epidural or local anesthesia. Neither complication nor anesthetic accident occurred during operation under acupuncture anesthesia. The use of acupuncture anesthesia for cesarean section was very safe not only for mother but also for her fetus. (4) Acupuncture anesthesia could be a good anesthetic method for cesarean section.