Canadian journal of anaesthesia = Journal canadien d'anesthésie
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As progress has been made in the acquisition of cardiac images with transoesophageal echocardiography, the technique has moved from the confines of the cardiology laboratory into the operating room, the intensive care unit, and the emergency department. This has afforded anaesthetists the opportunity to become familiar with, and develop expertise in its practice. The purpose of this article is to present a review of transoesophageal echocardiography with reference to anaesthetic practice. ⋯ Although the benefit of transoesophageal echocardiography is intuitive in many clinical situations, in others, it has not been shown to improve upon presently existing monitoring techniques. The need for adequate training and collaboration with cardiology colleagues is emphasized.
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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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Letter Randomized Controlled Trial Clinical Trial
Visual evaluation of TOF and DBS fade using a rubber band.
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Randomized Controlled Trial Clinical Trial
Placement of left double-lumen endobronchial tubes with or without a stylet.
This study was designed to determine if leaving a stylet in the left Bronch-Cath endobronchial tube (DLT) for the entire intubating procedure improves the accuracy of placement on the initial attempt, without introducing complications. ⋯ Retaining the stylet for the entire intubation procedure allows for a more rapid, accurate placement of the DLT without increasing the incidence of tracheobronchial mucosa injury.
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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.