Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Treatment with angiotensin-converting enzyme (ACE) inhibitors affects the autoregulation of renal blood flow and glomerular filtration and provides renal protective effects. The purpose of this case-control study was to investigate the effects of chronic ACE inhibition on perioperative renal hemodynamics and function. ⋯ Long term treatment with ACE inhibitors does not influence the perioperative changes in renal hemodynamics and function. During cardiopulmonary bypass, a transient impairment in solute reabsorption is associated with renal release of vasodilatory mediators (nitric oxide and prostacyclin).
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To evaluate the experience of the operator and the time of epidural anesthesia as factors contributing to unintentional dural puncture (UDP). ⋯ Operator experience and hour of procedure appear to be two important risk factors of UDP The increased risk of UDP in night-work could result from human factors such as fatigue, sleep deprivation or interruption.
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Randomized Controlled Trial Clinical Trial
Low dose axillary block by targeted injections of the terminal nerves.
To compare anesthetic time, success rate and adverse effects of axillary block by single or multiple injections of local anesthetic. ⋯ Small targeted injections of MEPE reduce total anesthetic time, give better spread of analgesia in the hand and forearm, and may be safer than a single large injection.
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The anesthetic management of a parturient with Strumpell's disease (hereditary or familial spastic paraparesis) who presented for Cesarean section is described. This neurological disorder is briefly reviewed and anesthetic implications of the condition are discussed. ⋯ Strumpell's disease is an inherited progressive spastic paresis predominantly affecting the lower extremities. Epidural anesthesia appears to be an appropriate technique when administering anesthesia for Cesarean section under similar circumstances.