Intravenous Dexamethasone for Prolonged Duration of Axillary Nerve Blockade.

Pain management among patients undergoing orthopedic surgery is often a challenge. Regional anesthesia has become a popular anesthetic technique providing optimal pain control during the intraoperative and postoperative periods. A 61-year-old woman presented for an open reduction and internal fixation of bilateral distal radius fractures.

Anesthetic considerations for an adult heart transplant recipient undergoing noncardiac surgery: a case report.

Approximately 3,500 Americans undergo heart transplantation each year. A portion of this patient population will possibly present later for an elective noncardiac surgery. Anesthesia professionals can be tasked to assess and provide the anesthesia management for heart transplant recipients undergoing a noncardiac surgical procedure.

Impact of goal-directed perioperative fluid management in high-risk surgical procedures: a literature review.

Guidelines for the perioperative administration of fluid are often based on static hemodynamic targets such as central venous pressure, and delayed volume status indexes such as blood pressure, heart rate, capillary refill, and urine output. Traditional fluid management protocols also rely heavily on algorithmic estimates of fluid deficit, intravascular fluid volume status, fluid loss, and basal fluid requirements to guide perioperative fluid administration. Such formulaic approaches lack definitive physiologic endpoints for determining fluid optimization and fail to address the roles of tissue oxygenation and end-organ perfusion in achieving positive long-term patient outcomes.

Rethinking the paradigm: evaluation of ketamine as a neurosurgical anesthetic.

Although anesthetists have long assumed that ketamine's role in neuroanesthesia is limited because of its association with increased intracranial pressure, this article presents a review of recent clinical literature suggesting otherwise. When ketamine is used as an adjuvant anesthetic agent along with mechanical ventilation to maintain normocapnia, ketamine does not have adverse cerebral hemodynamic effects. Furthermore, ketamine possesses a unique pharmacologic profile that provides analgesia, bronchodilation, and sympathetic stimulation, thereby reducing patients' vasoactive agent requirements.

Nonopioid anesthesia for awake craniotomy: a case report.

Awake craniotomy is becoming more popular as a neurosurgical technique that allows for increased tumor resection and decreased postoperative neurologic morbidity. This technique, however, presents many challenges to both the neurosurgeon and anesthetist. An ASA class II, 37-year-old man with recurrent oligodendroglioma presented for repeated craniotomy.