Canadian journal of anaesthesia = Journal canadien d'anesthésie
-
Sleep apnoea syndrome (SAS) is a relatively common, potentially fatal, disorder. Patients with SAS exhibit repetitive, often prolonged episodes of apnoea during sleep, with serious nocturnal and diurnal physiologic derangements. Several anecdotal reports and clinical studies have documented anaesthetic-related occurrence of fatal and near-fatal respiratory complications in these patients. The purpose of this article is to outline the potential problems encountered in anaesthetic management of adult SAS patients, and to suggest a practical approach for anaesthesia both for incidental and specific procedures. ⋯ Perioperative risks attending SAS patients emphasize the importance of their detection, perioperative evaluation and planning.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Preoperative ketorolac increases bleeding after tonsillectomy in children.
To compare the incidence of vomiting following codeine or ketorolac for tonsillectomy in children. ⋯ Preoperative ketorolac increases perioperative bleeding among children undergoing tonsillectomy without beneficial effects.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Epidural morphine vs hydromorphone in post-caesarean section patients.
The purpose of this randomized controlled double blind study was to compare the efficacy of pain relief and the side effects of epidural hydromorphone and morphine in post-Caesarean patients. ⋯ Hydromorphone provides no clinical benefit over epidural morphine for post operative analgesia following Caesarean section.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Acceleromyography improves detection of residual neuromuscular blockade in children.
To determine whether detection of residual blockade is improved by using the accelerograph. A secondary objective was to compare acceleromyographic measurements with those obtained by electromyography. ⋯ AMG is superior to visual assessment in detecting residual neuromuscular block and provides similar estimates of recovering block as the more cumbersome EMG.
-
Case Reports
Failure of neuromuscular blockade reversal after rocuronium in a patient who received oral neomycin.
Because the aminoglycoside antibiotics and nondepolarizing muscle relaxants have interactions that vary, it is necessary to update the potential for such interactions when new drugs are introduced clinically. Rocuronium is a newly released steroidal nondepolarizing muscle relaxant with an intermediate duration of action. The following report is the first description of prolonged neuromuscular blockage after rocuronium in a patient who had received oral neomycin in anticipation of open bowel resection. ⋯ Rocuronium, a new nondepolarizing muscle relaxant, has potential interactions with other drugs including the aminoglycoside antibiotics. This clinical report describes the failure of neuromuscular blockade reversal in a patient who received oral neomycin in anticipation of open bowel resection.