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1.
Article in English | WPRIM | ID: wpr-215140

ABSTRACT

Benedikt syndrome is characterized by ipsilateral ophthalmoplegia with contralateral hemichorea due to a midbrain lesion. A 67-year-old male with Benedikt syndrome underwent corpectomy at L1 and anterolateral interbody fusion at T12-L2 due to pathologic bursting fracture at L1 involving multiple myeloma. He had a history of traumatic subarachnoid hemorrhage and subdural hemorrhage 8 months before surgery. Magnetic resonance image of the brain revealed intracranial hemorrhage from thalamus to midbrain. Target controlled infusion with propofol and remifentanil were administered for anesthetic induction and maintenance and close hemodynamic and neurologic monitoring led to successful anesthetic management.


Subject(s)
Aged , Anesthesia , Brain , Hematoma, Subdural , Hemodynamics , Humans , Intracranial Hemorrhages , Male , Mesencephalon , Multiple Myeloma , Ophthalmoplegia , Propofol , Spine , Subarachnoid Hemorrhage, Traumatic , Thalamus
2.
Article in English | WPRIM | ID: wpr-177914

ABSTRACT

A 70-year-old woman with an infectious thrombus in her left internal jugular vein (IJV) underwent carotid endarterectomy for stenosis and a highly movable plaque in her right carotid artery. She had been treated with antibiotics for four weeks before surgery due to Lemierre syndrome, a rare septic thrombophlebitis in the IJV secondary to an oropharyngeal infection. The right IJV was in a two-fold dilated state due to compensation for a thrombotic left IJV. Accordingly, superficial cervical plexus block was performed under ultrasound guidance to ensure safety and accuracy. During surgery, the alertness was maintained and the patient did not complain of pain in the absence of additional analgesics. No block-related complications were encountered. The authors report for the first time their regional anesthetic experiences in a patient with Lemierre syndrome.


Subject(s)
Aged , Analgesics , Anti-Bacterial Agents , Carotid Arteries , Cervical Plexus Block , Cervical Plexus , Compensation and Redress , Constriction, Pathologic , Endarterectomy, Carotid , Female , Humans , Jugular Veins , Lemierre Syndrome , Thrombophlebitis , Thrombosis , Ultrasonography
3.
Article in English | WPRIM | ID: wpr-52555

ABSTRACT

BACKGROUND: 5-Hydroxytryptamine3 (5-HT3) receptor antagonists have been reported to attenuate spinal anesthesia-induced hemodynamic changes. This study was conducted to determine whether the second generation 5-HT3, antagonist palonosetron attenuates hypotension and bradycardia during spinal anesthesia. METHODS: Sixty adult patients scheduled for lower limb surgery were enrolled in this study. Patients were randomly assigned to receive either normal saline (Control group, N = 30) or palonosetron (0.075 mg, i.v.) (Palonosetron group, N = 30) prior to spinal anesthesia. Hemodynamic variables were recorded during anesthesia. RESULTS: The mean blood pressure (MBP) were 89.2 ± 11.4 mmHg in the control group and 87.6 ± 12.1 mmHg in the palonosetron group at 10 min after intrathecal injection (P = 0.609). The median blocked levels of the control group and the palonosetron group were T10 (interquartile range, 9-10) and T10 (8-10) at 20 min after intrathecal injection (P = 0.939). Requirements for ephedrine, phenylephrine, and atropine were similar (P = 0.652, 0.533 and 0.417, respectively). The incidences of hypotension (40% vs. 41%) and bradycardia (7% vs. 17%) were comparable (P = 0.562, P = 0.198, respectively) between the control and the palonosetron group. There were no significances in the changes of systolic blood pressure, diastolic blood pressure, MBP and heart rate by the group (P = 0.632, 0.287, 0.556, 0.733, respectively). CONCLUSIONS: Intravenous palonosetron (0.075 mg) prior to spinal anesthesia might not attenuate spinal anesthesia-induced hypotension during low level of neuroaxial block for lower limb surgery.


Subject(s)
Adult , Anesthesia , Anesthesia, Spinal , Atropine , Blood Pressure , Bradycardia , Ephedrine , Heart Rate , Hemodynamics , Humans , Hypotension , Incidence , Injections, Spinal , Lower Extremity , Orthopedics , Phenylephrine
4.
Article in Korean | WPRIM | ID: wpr-67735

ABSTRACT

BACKGROUND: The number of elderly patients undergoing surgery is steadily growing. Therefore, this study was designed to determine the prevalence and predictors of postoperative complications in patients older than 80 years. METHODS: The medical records of 532 patients above 80 years in age who underwent elective or emergent noncardiac surgery between June 2011 and May 2013 were reviewed retrospectively. Preoperative concomitant disease, operation site, anesthetic technique, and postoperative complications were analyzed. RESULTS: A total of 81.4% of the patients had pre-existing concomitant diseases, while 22.9% had severe systemic diseases. The incidence of severe complications within the first month after operation was 4.1%, and the in-hospital mortality rate was 1.3%. Among the severe postoperative complications, respiratory and cardiovascular complications were commonly observed. In multivariate logistic regression analysis, the predictors of postoperative severe complications included American Society of Anesthesiologists physical status classification of 3 or greater (odds ratio [OR], 5.271; 95% confidence interval [CI], 2.019-13.758; p=0.001), neurosurgery (OR, 23.132; 95% CI, 2.528-211.707; p=0.005) and duration of operation (OR, 1.006; 95% CI, 1.001-1.012; p=0.027). CONCLUSION: Proper preoperative evaluation and appropriate treatment for age-related concomitant diseases are suggested for patients older than 80 years in order to reduce postoperative complications. After operation, the respiratory and cardiovascular systems should be carefully monitored.


Subject(s)
Aged , Anesthesia , Cardiovascular System , Classification , Hospital Mortality , Humans , Incidence , Intraoperative Complications , Logistic Models , Medical Records , Neurosurgery , Postoperative Complications , Prevalence , Retrospective Studies
5.
Article in Korean | WPRIM | ID: wpr-83783

ABSTRACT

BACKGROUND: The patients with traumatic brain injury showed ischemia due to increased intracranial pressure. This study evaluated the relationship of pre-anesthetic serum lactate level with in-hospital mortality. METHODS: The archived medical records of 121 patients were retrospectively reviewed. Demographics and preoperative serum lactate level were analyzed. RESULTS: Of the 121 patients, 32 patients expired in the hospital after decompressive craniectomy. Preoperative serum lactate levels were 3.2 +/- 2.2 mmol/L in the survivors and 5.4 +/- 3.0 mmol/L in the dead (P = 0.001), and the receiver operating characteristic curve revealed that a cut off value of 3.60 mmol/L was reasonable for predicting mortality. CONCLUSIONS: Preoperative serum lactate level is highly correlated with in-hospital mortality after decompressive craniectomy in traumatic brain injury.


Subject(s)
Brain Injuries , Decompressive Craniectomy , Demography , Hospital Mortality , Humans , Intracranial Pressure , Ischemia , Lactic Acid , Medical Records , Mortality , Retrospective Studies , ROC Curve , Survivors
6.
Article in English | WPRIM | ID: wpr-56315

ABSTRACT

BACKGROUND: We evaluated whether the analgesic superiority of regional block over general anesthesia improves patient satisfaction. METHODS: Patients were anesthetized with either general anesthesia (GA) (n = 30) or axillary brachial plexus block (BPB) (n = 30). GA was standardized to include induction with propofol and alfentanil and maintenance with desflurane in an oxygen/nitrous oxide mixture. BPB was performed using an axillary perivascular approach, and 1.5% lidocaine 20 ml with epinephrine (1 : 200,000) and 0.5% levobupivacaine 20 ml were injected. Pain scores and numbers of times pushing the patient-controlled analgesia (PCA) button were measured preoperatively and at 2, 6, and 24 hours after the end of surgery. On the first day after the operation, one of our researchers visited the patients to document their opinions of their anesthetic experiences and their satisfaction scores. RESULTS: Group BPB had lower visual analog scale scores at 2 hours and 6 hours postoperatively. Numbers of times pushing the PCA button was also lower in Group BPB within the first 2 hours and between 2-6 hours postoperatively. However, patient satisfaction scores were not statistically different between the two groups (84 +/- 11 vs. 88 +/- 12, P = 0.177). CONCLUSIONS: BPB provided superior analgesia after upper limb surgery compared to GA, but for a complete understanding of patients' satisfaction, detailed consideration of factors such as sedation would be necessary.


Subject(s)
Alfentanil , Analgesia , Analgesia, Patient-Controlled , Anesthesia, General , Brachial Plexus , Epinephrine , Hand , Humans , Lidocaine , Passive Cutaneous Anaphylaxis , Patient Satisfaction , Propofol , Upper Extremity , Visual Analog Scale , Wrist
7.
Article in English | WPRIM | ID: wpr-227705

ABSTRACT

The patients with diabetes mellitus (DM) have abnormal cerebral auto-regulation and preexisting DM is one of the major factors related to adverse postoperative neurological deficits. New onset hemiparesis is a rare and devastating event in a patient awakening from general anesthersia. We report a case of transient hemiparesis after general anesthesia in a patient underwent laparoscopic cholecystectomy with uncontrolled DM.


Subject(s)
Anesthesia, General , Cholecystectomy, Laparoscopic , Diabetes Mellitus , Humans , Paresis
8.
Article in English | WPRIM | ID: wpr-227702

ABSTRACT

Paraneoplastic encephalitis associated with an ovarian teratoma has been related to the development of antibodies to specific heteromers of the N-methyl-D-aspartate receptor (NMDAR). The disorder, known as anti-NMDAR encephalitis, is characterized by psychiatric symptoms, seizures, mood and behavioral changes as well as involuntary movement. Since the NMDAR is the target of many anesthetic drugs, the presence of anti-NMDAR antibodies might influence the requirements of anesthetics or their effects. We report the presentation and anesthetic experience of a young patient with anti-NMDAR encephalitis undergoing surgical excision of two ovarian teratomas, and we also review the relevant literature.


Subject(s)
Anesthesia, General , Anesthetics , Anti-N-Methyl-D-Aspartate Receptor Encephalitis , Antibodies , Dyskinesias , Encephalitis , Humans , N-Methylaspartate , Paraneoplastic Syndromes , Seizures , Teratoma
9.
Article in Korean | WPRIM | ID: wpr-654533

ABSTRACT

The use of pulmonary artery catheter can be helpful in managing patients after cardiac surgery. Nevertheless, there is a risk of serious complications, such as knotting. A 61 year old man underwent tricuspid valve replacement under cardiopulmonary bypass (CPB). After implantation of a stented tissue valve in the tricuspid valve, repositioning of the catheter was performed. After weaning from CPB, an abnormal pattern of pulmonary artery pressure was suddenly observed on the monitor. Resistance was met when removing the catheter with the balloon deflated, at a 20 cm distance from the tip of the catheter. Chest radiography showed a knot in the catheter within the right brachiocephalic vein. Superior vena cava opened and the distal part of the catheter with the knot was successfully removed.


Subject(s)
Brachiocephalic Veins , Cardiopulmonary Bypass , Catheters , Humans , Organothiophosphorus Compounds , Pulmonary Artery , Stents , Thoracic Surgery , Thorax , Tricuspid Valve , Vena Cava, Superior , Weaning
10.
Article in Korean | WPRIM | ID: wpr-58159

ABSTRACT

BACKGROUND: Insufficient sample volume can cause unnecessary blood loss and inaccurate arterial blood gas and electrolytes testing. The aim of this study was to determine the adequate sample volume, that is required for accurate arterial blood gas and electrolyte testing from arterial catheters. METHODS: Patients had four different arterial blood samples (0.2 ml, 0.4 ml, 0.6 ml and 1 ml [control], respectively) taken sequentially in random order. Samples were analyzed for pH, PaCO2, PaO2, hematocrit, Na+, K+, Ca2+ and Mg2+ using NOVA blood gas analyzer. RESULTS: A total of 27 patients were recruited for the study. All sample volumes tested provided the results of pH, PaCO2, PaO2 and hematocrit that were statistically similar to control values. However, the results of electrolytes (K+, Ca2+ and Mg2+) in all sample volumes tested were significantly lower than the control values and an increasing sample volume equated to blood results trending closer to those obtained with the control sample. CONCLUSIONS: This study showed that there is not one sample volume that will provide accurate results for all blood components. The study tested a variety of sample volumes and found that although even small sample volume of 0.2 ml provided accurate results for pH, PaCO2, PaO2 and hematocrit. No sample volume that was tested provided accurate results for K+, Ca2+ and Mg2+.


Subject(s)
Electrolytes , Hematocrit , Humans , Hydrogen-Ion Concentration
11.
Article in English | WPRIM | ID: wpr-208516

ABSTRACT

Kartagener's syndrome (KGS) is an autosomal recessive disorder which possible to link the occurrence of abnormal ciliary movement and abnormal position of the body organs. Considering the fact that airway ciliary function plays an important role in the primary pulmonary defense mechanism, prevent the ciliodepressant actions are also important for anesthetic management. We described successful anesthetic management of a 44-year-old male scheduled for endoscopic sinus surgery who had a history of frequent epistaxis, anosmia and situs inversus totalis. Anesthesia was induced and maintained with propofol and remifentanil using a target controlled infusion device.


Subject(s)
Adult , Aluminum Hydroxide , Anesthesia , Anesthesia, Intravenous , Carbonates , Epistaxis , Humans , Kartagener Syndrome , Male , Olfaction Disorders , Piperidines , Propofol , Situs Inversus
12.
Article in Korean | WPRIM | ID: wpr-52308

ABSTRACT

BACKGROUND: Oxygen increases the cardiac vagal tone, blood pressure, systemic vascular resistance and vascular tone in healthy adults.This study assessed the autonomic tone according to different oxygen flow rates via different types of masks with using the heart rate variability (HRV) in the PACU after total intravenous anesthesia (TIVA). METHODS: We prospectively studied 27 patients after TIVA in the PACU.The 5 L group received oxygen via a simple mask with an oxygen rate of 5 L/min and the 10 L group received oxygen via a mask with a reservoir bag at a rate of 10 L/min in the PACU. We evaluated the HRV at the point of stabilization before anesthesia (BL), 5 min in the PACU (PACU 5), 30 min in the PACU (PACU 30) and 60 min in the PACU (PACU 60). RESULTS: In the 5 L group, the nuHF was increased to 42.4 +/- 24.2 at 60 min in the PACU as compared with 27.1 +/- 19.1 at 5 min in the PACU.In the 5 L group, the LFHFr was decreased to 2.3 +/- 2.1 at PACU 60 as compared with 6.6 +/- 9.7 at PACU 5 and the nuLF was decreased to 56.9 +/- 23.2 at PACU 60 as compared with 72.9 +/- 19.0 at PACU 5.There were no significant changes between the two groups at PACU 5, PACU 30 and PACU 60.The oxygen saturation was increased at PACU 60 compared with PACU 5 in the two groups. CONCLUSIONS: These finding indicates that 1 h of oxygen administration with 5 L/min during emergence from anesthesia increased the relative vagal tone, and the arterial blood pressure is stable irrespective of the oxygen flow rate.


Subject(s)
Anesthesia , Anesthesia, Intravenous , Arterial Pressure , Blood Pressure , Heart , Heart Rate , Humans , Masks , Oxygen , Prospective Studies , Vascular Resistance
13.
Article in Korean | WPRIM | ID: wpr-79313

ABSTRACT

BACKGROUND: This study was designed to assess the effects of pneumoperitoneum and positional changes on the autonomic nervous system (ANS) in laparoscopy-assisted vaginal hysterectomy (LAVH) patients. METHODS: Systolic blood pressures and R-R interval were recorded for 5 minutes in 22 patients, and then power spectral analyses were conducted to evaluate the ANS. The following variables were measured at various positions: preinduction (BASE), prepneumoperitoneum (PREPP), pneumoperitoneum at head-down (PP), normoperitoneum at supine (POSTPP). RESULTS: High frequency of heart rate variability (HRVHF), Low frequency of heart rate variability (HRVLF), Low frequency of blood pressure variability (BPVLF), LF/HF ratios of HRV (LFHFr) were significantly lower than that of BASE at PREPP. HRVHF, HRVLF, BPVLF were significantly lower than that of BASE at PP. At PP, normalized HF of HRV (nuHF) is significantly lower than that of BASE and normalized LF of HRV (nuLF) is significantly higher than that of BASE and PREPP (P < 0.05). LFHFr was significantly lower than that of BASE and significantly higher than that of PREPP at PP. At POSTPP, HRVHF, HRVLF, BPVLF were significantly lower than that of BASE. But, BPVLF at POSTPP was higher than that of PP. CONCLUSIONS: We conclude that the pneumoperitoneum and trendelenburg positions caused sympathetic activation in LAVH patients.


Subject(s)
Autonomic Nervous System , Blood Pressure , Female , Heart , Heart Rate , Humans , Hysterectomy, Vaginal , Methyl Ethers , Pneumoperitoneum
14.
Article in Korean | WPRIM | ID: wpr-143693

ABSTRACT

As a result of advanced surgical techniques, arthroscopy for shoulder surgery is becoming more common.Although serious complications from the absorption of fluid during shoulder arthroscopy are rare, significant absorption of irrigation fluid does occur during the procedure.This report describes a case of severe neck edema and pleural effusion following shoulder arthroscopy in a patient who received a large amount of arthroscopy fluid for irrigation.


Subject(s)
Absorption , Arthroscopy , Edema , Humans , Neck , Pleural Effusion , Shoulder
15.
Article in Korean | WPRIM | ID: wpr-143684

ABSTRACT

As a result of advanced surgical techniques, arthroscopy for shoulder surgery is becoming more common.Although serious complications from the absorption of fluid during shoulder arthroscopy are rare, significant absorption of irrigation fluid does occur during the procedure.This report describes a case of severe neck edema and pleural effusion following shoulder arthroscopy in a patient who received a large amount of arthroscopy fluid for irrigation.


Subject(s)
Absorption , Arthroscopy , Edema , Humans , Neck , Pleural Effusion , Shoulder
16.
Article in English | WPRIM | ID: wpr-44244

ABSTRACT

BACKGROUND: A reflex cough is often observed after an intravenous (IV) bolus of remifentanil. Since ketamine was reported to be effective in modulating the cough reflex, this prospective, randomized, double-blind, placebo-controlled study was designed to evaluate the efficacy of pretreatment with ketamine on remifentanil-induced cough. METHODS: 320 patients undergoing general anesthesia for elective surgery were randomly allocated into two groups to receive either IV ketamine 0.1 mg/kg (ketamine group, n = 156) or 0.9% saline (saline group, n = 154) 1 min before administration of remifentanil at a target effect-site concentration of 5 ng/ml. Severity of cough was graded (mild, 1-2; moderate, 3-4; and severe, 5 or >5). RESULTS: The overall incidence of cough was significantly higher in the saline group (43/154 patients; 0.28, 95% CI 0.21, 0.36) than that in the ketamine group (18/156 patients; 0.12, 95% CI 0.07, 0.18) (P < 0.001). However, there was no significant difference in the severity and the onset time of cough between the groups. CONCLUSIONS: IV ketamine 0.1 mg/kg one minute before remifentanil was effective in suppressing remifentanil-induced cough without affecting the severity and onset time.


Subject(s)
Anesthesia, General , Cough , Humans , Incidence , Ketamine , Piperidines , Prospective Studies , Reflex
17.
Article in Korean | WPRIM | ID: wpr-82533

ABSTRACT

BACKGROUND: Unheated CO2 insufflation can result in hypothermia during an extended operation, but heated CO2 may better preserve body temperature and arterial blood gas analysis. METHODS: Sixty-seven female patients scheduled for laparoscopic surgery were randomly divided to two groups. Group 1 (n = 37) and group 2 (n = 39) received unheated CO2 or heated CO2 during pneumoperitoneum, respectively. We compared body temperature and arterial blood gas parameters every 10 min or 15 min, respectively, during and after pneumoperitoneum and 30 min after postanesthesia care unit arrival. RESULTS: There were no significant differences in demographic data, hemodynamic data, body temperature, and arterial blood gas parameters between the two groups. CONCLUSIONS: Heated CO2 insufflation during laparoscopy does not dramatically affect body temperature or arterial blood gas parameters in relatively short procedures without other methods such as warm saline irrigation and prewarming of extremities.


Subject(s)
Blood Gas Analysis , Body Temperature , Extremities , Female , Hemodynamics , Hot Temperature , Humans , Hypothermia , Insufflation , Laparoscopy , Pneumoperitoneum
18.
Article in Korean | WPRIM | ID: wpr-29997

ABSTRACT

BACKGROUND: In ambulatory surgery, which is of short duration, anesthesiologists often do not use a muscle relaxant, or any other induction technique which could facilitate muscle relaxation for endotracheal intubation.Incomplete muscle relaxation, however, results in vocal cord movement and the possibility of damage to the vocal cords and adjacent structure.The aim of this study was to evaluate the macroscopic sequelae of intubation on vocal cord and laryngeal structure and assess postoperative sore throat or hoarseness. METHODS: 100 patients with class I or II ASA physical status were enrolled in this study.It was divided into two groups, Group C (conventional intubation dose of rocuronium; 0.6 mg/kg) and group L (low intubation dose 0.45 mg/kg).Anesthesia was induced with 10microgram/kg of alfentanil and 2.0 mg/kg of propofol i.v.Intubation was performed 90 second after rocuronium injection and the intubation condition was checked.Macroscopic sequelae ofthe laryngeal structure were evaluated using a flexible fiberoptic bronchoscope. After completion of surgery, the patient was asked to report sore throat or hoarseness. RESULTS: Macroscopic sequelae, such as erythema or hemorrhage, were statistically different between the two groups.There were no cases of minimal hemorrhage of either vocal cords or of the arryepiglottic folds in group C whereas there were two cases in group L.There was no statistical difference in incidence and severityof sore throat or hoarseness between the two groups. CONCLUSIONS: Although there were more macroscopic effects in the vocal cords and aryepiglottic folds, a low intubation dose of rocuronium can be used during surgery of short duration without fear of any significant sore throat or hoarseness after surgery.


Subject(s)
Alfentanil , Ambulatory Surgical Procedures , Androstanols , Bronchoscopes , Erythema , Hemorrhage , Hoarseness , Humans , Incidence , Intubation , Muscle Relaxation , Muscles , Pharyngitis , Propofol , Vocal Cords
19.
Article in Korean | WPRIM | ID: wpr-113486

ABSTRACT

BACKGROUND: Sevoflurane and propofol have different cardiorespiratory effects on postural changes. The purpose of this study was to compare the effects of sevoflurane and propofol on hemodynamics and gas exchange index when patients are raised from the supine position to the beach chair position. METHODS: Forty patients requiring beach chair position for shoulder surgery were randomly assigned to receive sevoflurane (end-tidal concentration 1 vol%, n = 20) or propofol (target concentration 3microgram/ml, n = 20). Hemodynamic variables and arterial blood gas analysis data were recorded and gas exchange indices were calculated before induction (baseline), 20 min after endotracheal intubation (supine position), and 20 min after beach chair position. RESULTS: There were significant decreases in mean arterial pressure, central venous pressure, and central venous oxygen saturation after beach chair position. There were no significant changes in gas exchange indices after the position changes. There were no significant differences between groups in hemodynamics and gas exchanges indices. CONCLUSIONS: Raising healthy patients from the supine to the beach-chair position produced a significant decrease in hemodynamic indices with little changes in gas exchange indices. However, the effects of sevoflurane and propofol on the both hemodynamic and gas change indices were not significantly different.


Subject(s)
Arterial Pressure , Blood Gas Analysis , Central Venous Pressure , Hemodynamics , Humans , Intubation, Intratracheal , Oxygen , Propofol , Shoulder , Supine Position
20.
Article in Korean | WPRIM | ID: wpr-81789

ABSTRACT

BACKGROUND: General anesthesia for cesarean section is usually maintained at a low dose after induction with using other agents. Many anesthesiologists have experience difficulty in maintaining stable blood pressure at intubation, as compared with nonobstetric anesthesia. We wanted to determine the efficacy of nicardipine for treating rising blood pressure that is related to intubation. METHODS: Twenty one parturient women, who were scheduled for elective cesarean section, were randomly allocated to two groups. Group 1 (n = 10) received no nicardipine and group 2 (n = 11) received nicardipine (7microg/kg) 60 seconds before intubation. The systolic blood pressures, diastolic blood pressures and heart rates were measured at preoperation, after induction of anesthesia, before intubation, immediately after intubation and at 1, 5, 10, 15 and 30 minutes after intubation. RESULTS: The systolic and diastolic blood pressures were lower in group 2 than group 1 at immediate after intubation. Yet the heart rate was higher in group 2 than in group 1 at the same time. CONCLUSIONS: Intravenous nicardipine given 60 seconds before intubation has some benefit from the viewpoint of blood pressure stability at intubation during cesarean section.


Subject(s)
Anesthesia , Anesthesia, General , Blood Pressure , Cesarean Section , Female , Heart Rate , Humans , Intubation , Intubation, Intratracheal , Nicardipine , Pregnancy
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