Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Comparative Study Clinical Trial
Equi-lasting doses of rocuronium, compared to mivacurium, result in improved neuromuscular blockade in patients undergoing gynecological laparoscopy : [Des doses de durée équivalente de rocuronium, comparé au mivacurium, améliorent la curarisation chez des patientes qui subissent une laparoscopie gynécologique].
To compare equi-lasting doses of a short-acting (mivacurium) to an intermediate-acting (rocuronium) neuromuscular relaxant, with regard to intubating conditions, efficacy, number of maintenance doses, hemodynamic alterations, adverse events and costs, in patients undergoing laparoscopic gynecological surgery. ⋯ Equi-lasting doses of rocuronium resulted in favourable intubating conditions more rapidly, improved hemodynamic stability, required less frequent administration of maintenance doses and were not associated with erythema, compared to mivacurium.
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Randomized Controlled Trial Clinical Trial
Intraoperative single-shot "3-in-1" femoral nerve block with ropivacaine 0.25%, ropivacaine 0.5% or bupivacaine 0.25% provides comparable 48-hr analgesia after unilateral total knee replacement.
To compare analgesia after intraoperative single shot "3-in-1" femoral nerve block (FNB) in combination with general anesthesia using ropivacaine 0.25%, ropivacaine 0.5% with bupivacaine 0.25% for total knee replacement (TKR). ⋯ "3-in-1" FNB with ropivacaine provided analgesia that was clinically comparable to that of bupivacaine up to 48 hr after TKR. Increasing the concentration of ropivacaine from 0.25% to 0.5% failed to improve the postoperative analgesia of "3-in-1" FNB.
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Comparative Study Clinical Trial
Point of care and central laboratory determinations of the aPTT are not interchangeable in surgical intensive care patients.
The objective of the study was to compare a bedside whole blood activated partial thromboplastin time (aPTT) performed by a point of care (POC) apparatus (CoaguCheck(R) Pro) in surgical intensive care (SIC) patients with a conventional aPTT obtained from the central laboratory. ⋯ POC aPTT and central laboratory aPTT showed a poor agreement in SIC patients admitted after surgery, although in healthy volunteers or in control patients, this agreement was better. The best test to monitor heparin treatment in this setting was anti-factor Xa activity.
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Randomized Controlled Trial Clinical Trial
Transdermal ketoprofen mitigates the severity of postoperative sore throat : [Le kétoprofène transdermique réduit le mal de gorge postopératoire].
To evaluate prospectively the incidence and severity of postoperative sore throat in 63 orotracheally intubated patients undergoing general anesthesia for various surgical procedures and to determine whether postoperative sore throat could be attenuated by treatment with the transdermal nonsteroidal anti-inflammatory drug ketoprofen applied on the anterior skin of the neck during operation. ⋯ This study suggests the pain caused by tracheal intubation is relieved by intraoperative topical use of transdermal ketoprofen.
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Case Reports
[Perioperative management of a patient with purpura fulminans syndrome due to protein C deficiency].
Protein C is a vitamin K-dependent anticoagulant and homozygous protein C deficiency is a rare fatal thrombotic disease. This report describes the perioperative management of homozygous protein C deficiency in a patient who underwent a total of three surgical procedures under general anesthesia and the successful use of activated protein C concentrate. ⋯ The perioperative management of homozygous protein C deficiency and purpura fulminans requires appropriate measures for thromboembolic prophylaxis. Sufficient iv fluid administration is necessary. Attention should be paid to decrease the risk of tissue compression such as that associated with positioning, blood pressure cuff, and endotracheal intubation, which may cause necrosis over pressure points. Replacement therapy with activated protein C concentrate appears safe and effective. The anesthetic management is reviewed and discussed.