Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Clinical Trial
Is lidocaine-prilocaine cream (EMLA) always useful for venous puncture in preoperative autologous blood donation?
The goal of the present study was to evaluate in adults the benefit of the Eutectic Mixture of Local Anesthetics (EMLA) for preoperative autologous blood donation. ⋯ In adults requiring repeated venous punctures, pain from cannulation may be evaluated at the first puncture with a Visual Analogue Scale, thus indicating or not the need for EMLA.
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To present a case of delayed neuraxial blockade after interscalene brachial plexus block. ⋯ This example of delayed central neural blockade complicating interscalene block is presented in contrast to other reports, which have usually occurred promptly after injection, accompanied by complete sensory and motor block requiring cardio-respiratory support. The presumed mechanism of the delayed onset of bilateral neuraxial spread was a dural cuff puncture with slow CSF spread from a plexus sheath "depot" of local anaesthetic.
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Case Reports
Unintentional intraoperative awareness during sufentanil anaesthesia for cardiac surgery.
The aim of this clinical report is to describe a case of unintentional intraoperative awareness during sufentanil anaesthesia in a patient undergoing elective aortocoronary bypass grafting. ⋯ Although awareness during opioid anaesthesia has been previously described with morphine and fentanyl, as far as we know this is the first clinical report of awareness with sufentanil. Given that recent efforts of early extubation in cardiac surgery patients may involve a reduction in the amount of opioid administered, this report serves as a reminder of the ever present potential for this disturbing complication.
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This case report describes the use of a Laryngeal Mask Airway in a morbidly obese parturient with the H.E.L.L.P. syndrome. An urgent Caesarean section was required because of vaginal bleeding and fetal distress. ⋯ The LMA has a place to facilitate potentially difficult awake tracheal intubation with the pregnant patient.