Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of the cardiovascular effects of cisatracurium and vecuronium in patients with coronary artery disease.
Cisatracurium besylate (Nimbex Injection, Glaxo Wellcome Inc., Research Triangle Park, NC) is an intermediate-acting bis-benzylisoquinolinium neuromuscular blocking drug that is one of the stereoisomers of atracurium. At doses < or = 8 x ED95, it caused no clinically important cardiovascular side effects or histamine release in healthy patients. The purpose of the present study was to investigate the haemodynamic effects of high doses of cisatracurium in patients with coronary artery disease. ⋯ In patients with coronary artery disease, rapid cisatracurium (4-8 x ED95) boluses and vecuronium (6 x ED95) result in minor, clinically insignificant haemodynamic side effects.
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Randomized Controlled Trial Clinical Trial
Analgesia following appendicectomy--the value of peritoneal bupivacaine.
Peritoneal inflammation is an important feature in many patients presenting with appendicitis. The contribution of peritoneal nerve fibres to pain experienced after appendicectomy has received little attention. ⋯ A combination of s.c. and peritoneal infiltration with bupivacaine is superior to skin infiltration alone in the relief of pain post appendicectomy.
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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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Letter Case Reports
Sevoflurane for oesophagoscopy in a patient with myotonic dystrophy.