Canadian journal of anaesthesia = Journal canadien d'anesthésie
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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.
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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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To compare the effectiveness of various laryngeal mask airway (LMA) sizes and their performance during positive pressure ventilation (PPV) in paralyzed pediatric patients. ⋯ Use of the LMA in smaller children results in more airway obstruction, higher ventilatory pressures, larger inspiratory leak, and more complications than in older children.
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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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To survey the general public's attitude towards preoperative assessment and commonly perceived fears about general anesthesia. ⋯ The general public considers anesthetic assessment on the day prior to surgery an important part of preoperative preparation. Fears of brain damage, death and intraoperative awareness associated with general anesthesia remain prevalent, suggesting that preoperative education of patients should address these concerns. The general population was less concerned about realistic fears such as nausea, vomiting and postoperative discomfort.