A healthy 53 year old man developed profound cardiogenic shock following instillation of bupivacaine-lidocaine-epinephrine solution as a locoregional anesthetic for elective outpatient shoulder surgery. Intubation, resuscitation, and transfer to the nearby hospital were done: echocardiography showed profound biventricular dysfunction; cardiac catheterization showed normal coronary arteries. Des...

Background Acute pain is a common concern after breast surgery, and despite the conventional management of with different analgesics, many patients have poor responses. Paravertebral, epidural, pectoral serratus plane blocks are regional blocks, which used commonly to control surgeries. Each these techniques has its advantages disadvantages. Erector spinae block (ESPB) new approach can provide ...

The term “total intravenous anesthesia” refers to the preservation of an anesthetic plane with use injectable anesthetic, a sedative that is often given in intermittent boluses. tendency have recurrent unprovoked seizures known as epilepsy. Its prevalence ranges from 0.5% 1%. highest incidence rates are those anatomical or developmental brain abnormalities, well at extremes age. most common tri...

Magnesium is necessary for the presynaptic release of acetylcholine from nerve endings and may produce effects similar to calciumentry-blocking drugs [1]. With the discovery of the N-methylD-aspartate (NMDA) receptor and its links to nociceptive pain transmission and central sensitization, there has been renewed interest in utilizing noncompetitive NMDA receptor antagonists, as potential antihy...

This case report describes anesthetic considerations for a 6-year-old boy, admitted for adenoidectomy under general anesthesia, who had a complicated medical history, including mastocytosis, Noonan syndrome, and von Willebrand disease. Each affected the anesthetic plan and was addressed preoperatively among all surgical and anesthesia providers. Mastocytosis created a major concern, with its in...

PURPOSE There is concern about the safety of anesthetic drugs (IVADs) in the management of status epilepticus (SE). To clarify this aspect, we aimed to assess the factors associated with a poor prognosis in SE requiring anesthetics. METHOD We analyzed all SE requiring IVADs between October 2011 and December 2015. Demographics, clinical data, etiology, SE duration, indications for sedation, el...

For various diseases clinicians have to combine different drugs or interventions when a single drug or intervention does not lead to satisfactory results. However, quantifying the relative benefit of certain drugs or interventions when given alone and in combination under controlled conditions requires a complex factorial design. This paper describes such a method applied to a large multicenter...