Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Clinical Trial Controlled Clinical Trial
Liver function after sevoflurane or isoflurane anaesthesia in neurosurgical patients.
Although both sevoflurane and isoflurane are thought to be less hepatotoxic than halothane or enflurane, recent case reports have described liver injury after sevoflurane or isoflurane anaesthesia. There are no studies comparing liver function after sevoflurane or isoflurane anaesthesia. The purpose of this study was to compare serum liver enzyme concentrations in patients receiving either sevoflurane or isoflurane anaesthesia prospectively. ⋯ Even in a small number of patients, isoflurane induced an elevation of serum levels of liver enzymes more frequently than did sevoflurane three to 14 days after anaesthesia.
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To determine the causes of failure of epidural analgesia during labour and delivery. ⋯ Several obstetrical and epidural-related factors increase the risk of inadequate epidural analgesia. For some, simple changes of practice pattern may lead to improved pain relief.
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The objectives of this multicentre survey were: first to ascertain whether the preoperative evaluation performed by anaesthetists in the preadmission anaesthesia consultation clinic (PACC) is influenced by the knowledge that they will or will not be the patient's attending anaesthetist; and second to determine the agreement among anaesthetists with regard to investigations requested. ⋯ The extent of investigation in the PACC scenarios was not affected by knowledge of whether or not the consulting anaesthetist would be the attending anaesthetist in the operating room. However, there was minimal agreement among anaesthetists concerning the preoperative evaluation of the patients, regardless of who would be the anaesthetist on the day of operation. Efficiency in preoperative evaluation could be increased if anaesthetists saw their own patients in the PACC, or if clinical guidelines for patient assessment were introduced by departments.
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To compare retrospectively liver and renal function after repeated exposure (twice) to sevoflurane or isoflurane. ⋯ Repeat exposure to sevoflurane or isoflurane within 30 to 180 days had no additional risk of increasing serum concentration of liver enzymes or increasing urinary excretion of protein and glucose compared with the first exposure to the same anaesthetic.
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Letter Case Reports
Sevoflurane for oesophagoscopy in a patient with myotonic dystrophy.