Canadian journal of anaesthesia = Journal canadien d'anesthésie
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To determine the incidence of gastroesophageal reflux during general anesthesia with the Laryngeal Mask Airway (LMA). ⋯ This study suggests that the lithotomy position predisposes patients to a higher risk of aspiration than the supine position when using a LMA.
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Randomized Controlled Trial Clinical Trial
Control of shivering under regional anesthesia in obstetric patients with tramadol.
Tramadol in a dose of 1 mg x kg(-1) iv is effective in the treatment of shivering after general anesthesia. The current study aimed to investigate (1) whether tramadol was equally effective for shivering under regional anesthesia in obstetric patients and (2) whether effective treatment could be achieved with lower doses. ⋯ We conclude that tramadol iv was effective in the treatment of intraoperative shivering during regional anesthesia for Cesarean section. There was no demonstrable difference in response rate or incidence of side effects between the two doses of 0.5 mg x kg(-1) and 0.25 mg x kg(-1).
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Randomized Controlled Trial Clinical Trial
Laryngo-pharyngeal complaints after use of the laryngeal mask airway.
To compare the incidence of dysphagia, dysphonia and sore throat following anesthesia, using the laryngeal mask airway (LMA), among patients receiving intermittent positive-pressure ventilation (IPPV) and those breathing spontaneously (SV) and with two different concentrations of nitrous oxide (N2O) in oxygen. ⋯ Post-operative discomfort is related to the type of ventilation but not to variation in LMA cuff pressure.
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Case Reports
Epidural hematoma following epidural catheter placement in a patient with chronic renal failure.
We report a case of epidural hematoma in a surgical patient with chronic renal failure who received an epidural catheter for postoperative analgesia. Symptoms of epidural hematoma occurred about 60 hr after epidural catheter placement. ⋯ We report the first case of epidural hematoma formation in a surgical patient with chronic renal failure (CRF) and epidural postoperative analgesia. The only risk factor for the development of epidural hematoma was a history of CRF High-risk patients should be monitored closely for early signs of cord compression such as severe back pain, motor or sensory deficits. An opioid or opioid/local anesthetic epidural solution, rather than local anesthetic infusion alone, may allow continuous monitoring of neurological function and be a prudent choice in high-risk patients. If spinal hematoma is suspected, immediate MRI or CT scan should be done and decompressive laminectomy performed without delay.
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Comment Letter
The difficult airway and BURP--a truly Canadian perspective.