Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Case Reports
Transesophageal echocardiography diagnosis of tricuspid obstruction by a vena cava tumour.
To present the anesthetic management for excision of a primary tumour of the inferior vena cava. ⋯ Tricuspid obstruction due to postoperative mobilization of a primary tumour of the inferior vena cava was diagnosed by transesophageal echocardiography. Perioperative management particularities of the primary tumour of the vena cava are discussed.
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The aim of this study was to assess the incidence and causes of cardiac arrests related to anesthesia. ⋯ Efforts must be directed towards improving preoperative patient evaluation. Anesthetic induction doses should be titrated in all ASA 3 and 4 patients. The prediction of difficult tracheal intubation, and if required, the use of awake tracheal intubation techniques, should remain a priority when performing general anesthesia.
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Review
Safety and efficacy of o-raffinose cross-linked human hemoglobin (Hemolink) in cardiac surgery.
There are currently two major classes of oxygen therapeutics: hemoglobin based oxygen carriers (HBOCs) and synthetic perfluorocarbons (PFCs). This review focuses on the use of o-raffinose cross-linked human hemoglobin (Hb raffimer) in cardiac surgery. ⋯ The converging evidence from clinical studies with HBOCs has demonstrated that these products have the potential to provide hemoglobin and oxygen carrying capacity to tissues in times of acute anemia during surgery. It is anticipated that Hb raffimer will be used to facilitate intraoperative autologous donation and emerge as an important alternative to allogeneic blood transfusion during cardiac surgery.
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Case Reports
Anesthesia for Cesarean section and posterior fossa craniotomy in a patient with von Hippel-Lindau disease.
To describe the care of a pregnant woman with von Hippel-Lindau disease (VHLD) and intracranial mass lesions. ⋯ Patients with VHLD may have worsening of preexisting lesions or develop other lesions during pregnancy. Some asymptomatic lesions can increase the risk for anesthesia complications. These patients need comprehensive assessment before administration of anesthesia.
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Case Reports
Ambulatory surgery for multi-ligament knee reconstruction with continuous dual catheter peripheral nerve blockade.
Major reconstructive surgery of the knee traditionally requires an extended hospital stay for pain management. Continuous peripheral nerve blockade is an alternative method of pain control but is seldom used in the ambulatory setting. This case illustrates the use of lumbar plexus and sciatic nerve peripheral catheters for major knee surgery using intermittent bolus dosing for outpatient analgesia. ⋯ The use of a lumbar plexus and sciatic nerve peripheral catheter offered an alternative to conventional pain control that worked well in the ambulatory setting. By providing prolonged unilateral lower limb analgesia, extensive knee surgery was performed that would normally require a hospital stay for pain control. Using a bolus dosing method the risk of local anesthetic complications occurring outside of the hospital with a continuous infusion was minimized.