Canadian journal of anaesthesia = Journal canadien d'anesthésie
-
Randomized Controlled Trial Clinical Trial
Epidural anesthesia with lidocaine reduces propofol injection pain.
To determine whether epidural lidocaine reduces the severity of propofol injection pain compared with iv lidocaine. ⋯ Epidural and iv lidocaine equally reduced the severity of propofol injection pain despite higher lidocaine plasma concentrations in epidurally administered lidocaine.
-
Case Reports
Use of inhaled nitric oxide for emergency Cesarean section in a woman with unexpected primary pulmonary hypertension.
Use of inhaled nitric oxide (iNO) could be of importance in emergency cases of primary pulmonary hypertension (PPH) in pregnant patients during labour and delivery. iNO acts as a selective pulmonary bed vasodilator avoiding systemic hemodynamic effects due to its ease of administration. Pulmonary bed vasodilation improves right ventricular function directly and left ventricular function indirectly. ⋯ The ease of administration of iNO allowed the optimal control of pulmonary arterial hypertension. No interaction with epidural anesthesia was observed. Use of iNO can improve the management of urgent CS in women with unexpected PPH.
-
Randomized Controlled Trial Clinical Trial
Intrathecal bupivacaine with morphine or neostigmine for postoperative analgesia after total knee replacement surgery.
To compare the postoperative analgesic efficacy and safety of intrathecal (IT) neostigmine and IT morphine in patients undergoing total knee replacement under spinal anesthesia. ⋯ IT neostigmine 50 microg produced postoperative analgesia lasting about seven hours with fewer side effects and better satisfaction ratings than IT morphine 300 microg.
-
Whereas patients most often select their surgeon, they don't usually select their anesthesiologist. Further, anesthesia frequently involves different physicians at different stages perioperatively. This inability to choose and the multiplicity of interveners may reduce patient satisfaction. Our study examined patients' willingness to choose their anesthesiologist for the operation, as well as their opinion on the way anesthesia is practiced presently. ⋯ In France, the preoperative visit is required by law and must precede the operation by at least 48 hr. Despite this preoperative interview, patients were unwilling to choose the anesthesiologist responsible for surgery, did not object to multiple interveners and seldom remembered their anesthesiologist's name. Efforts to improve the image of the profession are required.