Abstract：
STUDY OBJECTIVE:Lambert-Eaton myasthenic syndrome (LEMS) is an autoimmune disorder of the neuromuscular junction that manifests with muscle weakness, autonomic and bulbar dysfunction, and increased sensitivity to neuromuscular blocking drugs. The objective of this study is to review perioperative outcomes on a series of patients with LEMS. DESIGN:The medical records of surgical patients with LEMS from January 1, 1990, to December 31, 2012, were retrospectively reviewed. SETTING:Major academic hospital. PATIENTS:Surgical patients with LEMS. MEASUREMENTS AND MAIN RESULTS:Thirty-seven patients underwent 60 surgeries, with most performed to diagnose or treat lung malignancy (n = 31; 51.7%). Equal number of patients had LEMS associated with small cell lung cancer (n = 16; 43.2%) or an autoimmune process (n = 16; 43.2%), with the remainder having various malignancies. Neuromuscular blocking drug medications were used in 23 (38.3%) of cases, including 8 patients who were not treated for LEMS symptoms. Four patients (11%) had respiratory complications. Interestingly, 3 patients were either undiagnosed or not treated for LEMS at the time of perioperative complication, and developed weakness after use of neuromuscular blocking drugs. CONCLUSION:Patients with LEMS have increased sensitivity to neuromuscular blocking drugs. The risk for the development of prolonged muscle weakness or postoperative respiratory failure after being exposed to neuromuscular blocking drugs is increased in patients with undiagnosed or untreated LEMS.
journal_name
J Clin Anesthjournal_title
Journal of clinical anesthesiaauthors
Weingarten TN,Araka CN,Mogensen ME,Sorenson JP,Marienau ME,Watson JC,Sprung Jdoi
10.1016/j.jclinane.2014.09.009subject
Has Abstractpub_date
2014-12-01 00:00:00pages
648-53issue
8eissn
0952-8180issn
1873-4529pii
S0952-8180(14)00322-5journal_volume
26pub_type
杂志文章abstract：STUDY OBJECTIVE:Perioperative fasting guidelines differ in their approaches to chewing gum in the preoperative period. Current recommendations range from canceling the surgery to proceeding with it. Given this lack of consensus, we performed gastric ultrasound assessments in healthy volunteers before and after a standa...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2019.01.021
更新日期：2019-09-01 00:00:00
abstract：:Turner syndrome is a complex and common genetic disorder that affects women and is associated with a wide variety of anatomic and physiological disorders. These abnormalities, especially those relating to the airway and cardiovascular system, pose a challenge to the anesthesiologist. We report a case of Turner syndrom...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2004.06.010
更新日期：2005-03-01 00:00:00
abstract：STUDY OBJECTIVE:To compare the intraoperative effects and recovery characteristics when either midazolam or propofol was used for sedation during local or regional anesthesia. DESIGN:Open-label, randomized study with blinded observer assessing recovery data. SETTING:Outpatients undergoing elective surgical procedures...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/0952-8180(91)90203-y
更新日期：1991-01-01 00:00:00
abstract：OBJECTIVE:The American Society of Anesthesiologists physical status (ASA-PS) is associated with increased morbidity and mortality in the perioperative period. When surgeries are scheduled by surgeons and their staff at our large institution a presumed ASA-PS is chosen. This is because our institution (and, anecdotally,...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2017.02.002
更新日期：2017-05-01 00:00:00
abstract：:Vagus nerve stimulation (VNS) for medically refractory seizures has been an approved therapy by the Food and Drug Administration since 1997, with additional approval as an adjunct therapy for major depression granted in 2005. Potential applications for VNS therapy in obesity, neuropsychiatric disorders, and chronic pa...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,评审
doi：10.1016/j.jclinane.2009.10.002
更新日期：2010-05-01 00:00:00
abstract：:We report a case of guide wire loss and migration after central venous access for spinal deformity surgery. Guide wire migration was noticed on a follow-up full spine x-ray 69 days postoperatively. Percutaneous retrieval was successfully performed using endovascular techniques. With this case report, we want to highli...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2015.04.005
更新日期：2015-08-01 00:00:00
abstract：STUDY OBJECTIVE:To assess the impact of intraoperative hemodynamics in the development of perioperative myocardial infarction (MI) and myocardial ischemia after noncardiac surgery. DESIGN:Single-center retrospective cohort study of surgical patients from 2007 to 2012. SETTING:Postanesthesia care unit, intensive care ...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2016.05.009
更新日期：2016-11-01 00:00:00
abstract：:A 30-year-old parturient requested epidural analgesia during labor. Immediately after the epidural space was presumably identified using the loss-of-resistance-to-air technique, she reported severe back pain, followed by neck pain, which progressed to severe unrelenting headache. An emergency computerized tomographic ...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/0952-8180(91)90188-s
更新日期：1991-09-01 00:00:00
abstract：STUDY OBJECTIVE:To determine whether a new Sonoclot-based, aprotinin-insensitive activated clotting time (aiACT) assay yields stable results over a broad range of aprotinin concentrations. DESIGN:Prospective trial conducted on in vitro blood samples. SETTING:Tertiary-care teaching medical center. PARTICIPANTS:19 hea...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2007.03.003
更新日期：2007-09-01 00:00:00
abstract：:We report two patients with a history of dural puncture who developed paradoxical postural cerebrospinal fluid leak-induced headache. The patients' headache worsened when they were in the recumbent position, and it improved when they were placed upright. Both patients had a history of migraine headache. The patients w...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2008.01.011
更新日期：2008-08-01 00:00:00
abstract：:A case of unusual triple knotting of a central venous catheter inserted through the left basilic vein is reported. The catheter with intact triple knots could be withdrawn without an invasive maneuver. A possible cause of triple knotting was discussed in regard to the anatomic configuration of the central veins. This ...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/0952-8180(89)90045-7
更新日期：1989-01-01 00:00:00
abstract：STUDY OBJECTIVES:To evaluate the effects of fentanyl on the cardiorespiratory system in elderly patients undergoing cataract surgery with phacoemulsification method. DESIGN:Randomized, prospective, double-blind study. SETTING:University hospital. PATIENTS:70 ASA physical status I, II, and III patients (>60 years) wh...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/j.jclinane.2003.05.008
更新日期：2004-03-01 00:00:00
abstract：:We present a case of postoperative cardiac arrest caused by extrinsic occlusion of the right coronary artery by an aortic pseudoaneurysm. Extrinsic impingement upon the coronary arteries may result from several etiologies and lead to cardiac symptoms identical to those caused by intrinsic coronary disease. Extrinsic c...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2005.06.013
更新日期：2006-05-01 00:00:00
abstract：:Arterial misplacement of the Swan-Ganz catheter occurs occasionally and usually can be easily detected. However, in some special clinical settings, the problem may become more complicated. We report a case of chronic obstructive pulmonary disease in which, because of severe hypoxemia, systemic hypotension, and pulmona...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/0952-8180(95)00032-d
更新日期：1995-06-01 00:00:00
abstract：STUDY OBJECTIVE:Obesity has detrimental effects on general health and respiratory function. This study aimed to evaluate respiratory muscle strength in the morbidly obese population, before and after bariatric surgery, and to compare these estimates with the predictive values using different mathematical equations avai...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2016.03.005
更新日期：2016-08-01 00:00:00
abstract：OBJECTIVE:When dexmedetomidine is used in patients undergoing spinal anesthesia, high incidence of bradycardia in response to parasympathetic activation is reported. Therefore, we aimed to evaluate the effectiveness of atropine premedication for preventing the incidence of bradycardia and the hemodynamic effect on pati...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jclinane.2016.07.012
更新日期：2016-12-01 00:00:00
abstract：:We present a case in which an anemic patient with religious objections to blood transfusion experienced three episodes of severe myocardial ischemia during the perioperative period. The first episode of ischemia was successfully treated by discontinuing isoflurane and resolving the hypotension. The second and third ep...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/0952-8180(96)00086-4
更新日期：1996-08-01 00:00:00
abstract：STUDY OBJECTIVE:Our hypothesis was that a pre-operative posteromedial quadratus lumborum (QL) block would reduce postoperative morphine consumption and provide superior analgesia in the setting of multimodal analgesia compared with a lateral transversus abdominis plane (TAP) block for laparoscopic colorectal surgery. ...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2020.109716
更新日期：2020-06-01 00:00:00
abstract：STUDY OBJECTIVE:To compare the efficacy of patient-controlled analgesia (PCA) to physician-controlled analgesia in patients undergoing extracorporeal shock wave lithotripsy (ESWL). DESIGN:Prospective, randomized trial. SETTING:New Jersey Kidney Stone Treatment Center at Robert Wood Johnson University Hospital, New Br...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/0952-8180(95)00008-6
更新日期：1995-05-01 00:00:00
abstract：STUDY OBJECTIVE:To compare spinal anesthesia and combined sciatic-femoral nerve block for outpatient knee arthroscopy. DESIGN:Prospective, randomized, controlled study. SETTING:Postoperative recovery area at a university-affiliated medical center. PATIENTS:50 ASA physical status I and II adult outpatients undergoing...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jclinane.2008.04.003
更新日期：2008-09-01 00:00:00
abstract：:Visualization of thromboembolic material in the pulmonary artery is often difficult on transesophageal echocardiography, especially in the left pulmonary artery, because of the position of the left main bronchus. We present a case in which thromboembolic material within the midleft pulmonary artery was incidentally di...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2007.06.026
更新日期：2008-03-01 00:00:00
abstract：:Data on all obstetric patients delivering at the Brigham and Women's Hospital during the years 1982 through 1987 were collected. The anesthetic techniques used, the type and amount of anesthetic agents administered, and the postpartum relapse rate of multiple sclerosis patients were compared. Women who received epidur...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/0952-8180(88)90006-2
更新日期：1988-01-01 00:00:00
abstract：STUDY OBJECTIVES:To examine whether epidural administration of neostigmine reduces the stress and inflammatory responses thereby improving postoperative pain status. DESIGN:Randomized, double-blinded clinical study. SETTING:Operating rooms and wards of a university hospital. PATIENTS:40 ASA physical status I patient...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/j.jclinane.2003.12.009
更新日期：2004-11-01 00:00:00
abstract：STUDY OBJECTIVE:To determine how often pediatric anesthesiologists follow the American Heart Association (AHA) recommendations for the administration of prophylactic antibiotics to prevent bacterial endocarditis (BE). DESIGN:Questionnaires mailed to all members of the Society for Pediatric Anesthesia regarding their u...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/0952-8180(94)90109-0
更新日期：1994-01-01 00:00:00
abstract：:A 21 year old healthy parturient was diagnosed as having a fetus with micrognathia. She was scheduled for an ex-utero intrapartum treatment (EXIT) procedure. General anesthesia consisted of remifentanil, nitrous oxide, and midazolam. Intravenous nitroglycerin was used for uterine relaxation. This technique offered hem...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2009.12.014
更新日期：2011-03-01 00:00:00
abstract：STUDY OBJECTIVE:To determine the significance of pain and other symptoms on the recovery process after ambulatory surgery, by surveying pain, analgesic use, and related aspects of recovery in the first 48 hours after discharge from an ambulatory surgery unit. DESIGN:Prospective, observational, surveillance survey. PA...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2003.08.004
更新日期：2004-05-01 00:00:00
abstract：STUDY OBJECTIVE:To understand anesthesiologists' and surgeons' risk attitudes about expected years of life. DESIGN:Prospective study. SETTING:Central operating rooms (ORs) in a university hospital. RESPONDENTS:122 anesthesiologists and surgeons. MEASUREMENTS AND MAIN RESULTS:A 7-page survey questionnaire regarding ...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/s0952-8180(00)00130-6
更新日期：2000-03-01 00:00:00
abstract：STUDY OBJECTIVE:To compare analgesia and opioid-related side effects of intrathecal morphine and intrathecal hydromorphone after elective Cesarean delivery. DESIGN:Retrospective, comparative study. SETTING:Labor and delivery unit of an academic hospital. PATIENTS:114 parturients age ≥ 18 years, presenting for electi...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2013.01.014
更新日期：2013-08-01 00:00:00
abstract：:Obstructive sleep apnea (OSA) is associated with postoperative airway obstruction, hypoxemia, cardiac arrhythmias, cardiorespiratory arrest, hypoxic encephalopathy, and death. Three cases highlighting important issues in patients with OSA are presented that occurred prior to and after implementation of an OSA protocol...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2008.08.023
更新日期：2009-06-01 00:00:00
abstract：:This study examines whether epidural anesthesia is more effective than general anesthesia using an inhalation agent in controlling cardiovascular responses during femoral-popliteal bypass surgery. Nineteen patients were randomized into two groups: general anesthesia (n = 10) and epidural anesthesia (n = 9). The patien...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/0952-8180(90)90056-9
更新日期：1990-03-01 00:00:00
