Canadian journal of anaesthesia = Journal canadien d'anesthésie
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The literature describing the pulmonary mechanisms of increased PA-PaO2 during general anaesthesia was examined to define the role of airway closure and sub-radiological atelectasis. ⋯ Airway closure and atelectasis contribute equally to the increased ventilation: perfusion mismatching that occurs during general anaesthesia.
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Randomized Controlled Trial Clinical Trial
The reversal of profound mivacurium-induced neuromuscular blockade.
Mivacurium is metabolized by plasma cholinesterase catalyzed ester hydrolysis. Acetylcholinesterase antagonists used in the reversal of muscle relaxation may also inhibit plasma cholinesterase and, therefore, delay the hydrolysis of mivacurium. The clinical interaction between acetylcholinesterase antagonists and mivacurium induced neuromuscular blockade was studied. ⋯ Neostigmine reversal of intense mivacurium neuromuscular block should be avoided, as this may result in prolongation of the block.
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We report a case of a parturient with peroneal muscular atrophy-Charcot-Marie-Tooth disease type 1 (CMT)-who received epidural analgesia for labour. The effects of pregnancy and labour on the course of CMT are reviewed, together with the current literature on the provision of epidural and general anaesthesia in this disease. ⋯ Epidural analgesia, after thorough discussion with the patient, may be offered to parturients with CMT.
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Single-use commercial forced air warming blankets serve only to distribute heated air from a blower. Standard bed sheets may be equally effective in delivering hot air within a lower body field and at lower cost. ⋯ The simplicity, efficacy and economy of containing 38 degrees warm air beneath bed-sheets offer several advantages over commercial blankets and warrant further study.