Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Clinical Trial
Epidural ketamine reduces post-operative epidural PCA consumption of fentanyl/bupivacaine.
To study the analgesic effect of epidural ketamine on postoperative pain and epidural PCA consumption after total abdominal hysterectomy. ⋯ Epidural ketamine 30 mg reduces post hysterectomy pain as evidenced by prolongation of time to first analgesia request and reduction in postoperative epidural PCA consumption. This effect is manifest whether ketamine is given before induction or 20 min after skin incision.
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Randomized Controlled Trial Clinical Trial
Awake removal of the laryngeal mask airway is safe in paediatric patients.
It has been suggested that it is safer to remove the Laryngeal Mask Airway (LMA) in paediatric patients when they are deeply anaesthetised than when they are awake. However, the evidence regarding this recommendation is contradictory. The purpose of the study was to compare the incidence of complications (laryngeal spasm, bronchospasm, coughing, retching, excessive salivation and oxygen desaturation) associated with removal of the LMA in children. ⋯ There was no difference in the incidence of airway complications whether the LMA was removed in the anaesthetised or the awake child.
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To measure the haemodynamic effects of rocuronium in adults undergoing cardiac surgery with cardiopulmonary bypass (CPB). ⋯ The haemodynamic profile for a 0.6 mg.kg-1 bolus of rocuronium is acceptable for patients with cardiovascular disease.
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Respiratory acidosis during carbon dioxide (CO2) insufflation has been suggested as a cause of spontaneous abortion and preterm labour following laparoscopic cholecystectomy during pregnancy. Capnography may not be adequate as a guide to adjust pulmonary ventilation during laparoscopic surgery and hence arterial carbon dioxide (PaCO2) monitoring has been recommended. We report the feasibility and benefits of transcutaneous carbon dioxide monitoring (PtcCO2) as an approach to optimise ventilation during laparoscopic surgery in pregnancy. ⋯ Continuous PtcCO2 measurements as well as squeeze PETCO2 may be of clinical value in trending and preventing hypercarbia during laparoscopic surgery.
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To report the successful perioperative anaesthetic and analgesic management of a spinal trauma patient with a surgically placed epidural catheter. ⋯ A surgically placed epidural catheter provided excellent, safe, perioperative anaesthesia and analgesia in this patient with unstable spinal trauma.