Canadian journal of anaesthesia = Journal canadien d'anesthésie
-
Major breast cancer surgery is associated with a high incidence of postoperative nausea, vomiting and pain. Regional anaesthesia, with intraoperative sedation, would seem an ideal alternative to general anaesthesia for this type of surgery. We report our initial experience using paravertebral blocks (PVB) to provide anaesthesia for major breast surgery. ⋯ Our initial results show that PVB for breast cancer surgery can be successfully performed in a majority of patients with few side effects. All patients with successful blocks were returned to the ambulatory care unit, bypassing the recovery room. That breast cancer surgery under regional anaesthesia can be safely performed as an ambulatory procedure has the potential for accomplishing major cost-saving.
-
Airway management in neurosurgical patients presents unique challenges to the anaesthetist. This review will consider specific approaches to numerous problems in airway management related to logistical, physiological and anatomical concerns. The goal is to provide a clinically oriented and practical discussion regarding issues of airway management in neurosurgical patients. ⋯ The demands for airway management in neuroanaesthesia require expertise in the various modes of securing the airway while considering the patient's physiological requirements as well as the unique surgical demands.
-
Randomized Controlled Trial Clinical Trial
Determination of end-tidal sevoflurane concentration for tracheal intubation in children with the rapid method.
Using the conventional method of determining the end-tidal concentration of inhalational anaesthetic for tracheal intubation, a constant end-tidal anaesthetic concentration is maintained for at least 15 min. As sevoflurane has a low tissue/gas partition coefficient, it seems possible in paediatric patients to determine end-tidal concentrations for tracheal intubation more rapidly by using a high inspired concentration. We determined ED50 and ED95 of sevoflurane for tracheal intubation, the end-tidal concentrations that prevented 50% and 95% of patients from coughing and gross purposeful muscular movements after intubation. ⋯ In paediatric patients, this method enabled determination of ED50 and ED95 end-tidal sevoflurane concentrations for tracheal intubation without obtaining a long stabilization period.
-
This study assessed the accuracy of photometer based haemoglobin (Hb) determination technology (HemoCue) when used by different anaesthetists in situations of rapidly changing Hb values during anaesthesia. ⋯ The HemoCue haemoglobinometer has sufficient accuracy to support treatment decisions regarding blood transfusions.
-
Randomized Controlled Trial Clinical Trial
Saphenous nerve anaesthesia--a nerve stimulator technique.
This two part study was undertaken to assess both the feasibility of identifying the saphenous nerve with a nerve stimulator and to assess the efficacy of saphenous nerve anaesthesia with electrical isolation of the nerve. ⋯ (Part I): The first part of the study established the feasibility of electrical identification of the saphenous nerve and demonstrated that the NS technique could be utilized to provide superior anaesthesia of the saphenous nerve when compared with a previously validated LOR technique. (Part II): The clinical utility of the NS technique of saphenous nerve block was successfully demonstrated.