Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Clinical Trial
Clonidine as adjuvant for mepivacaine, ropivacaine and bupivacaine in axillary, perivascular brachial plexus block.
To evaluate the effects of clonidine on three local anesthetics (mepivacaine 1%, ropivacaine 0.75% and bupivacaine 0.5%) with comparable potency and almost the same concentration-response relationship. ⋯ The present study shows that the addition of clonidine has a different impact on each of the three local anesthetics investigated in terms of onset and duration of block.
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About 1% to 3% of laryngoscopic intubations can be difficult or impossible. Light-guided intubation has been proven to be an effective, safe, and simple technique. This article reviews current knowledge about the newer version lightwand: the Trachlight (TL). ⋯ Based on the clinical reports available, the TL has proven to be a useful option for tracheal intubation. In addition, the device can also be used together with other intubating devices, such as the intubating LMA and the laryngoscope, to improve intubating success rates. A clear understanding of the principle of transillumination of the TL, and an appreciation of its indications, contraindications, and limitations, will improve the effectiveness of the device as well as reducing the likelihood of complications. Finally, regular practice with the TL with routine surgical patients requiring tracheal intubation will further improve intubation success rates.
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Randomized Controlled Trial Clinical Trial
Pain after laparoscopic cholecystectomy: the effect and timing of incisional and intraperitoneal bupivacaine.
To examine the combined preemptive effects of somatovisceral blockade during laparoscopic cholecystectomy (LC). ⋯ Incisional pain dominated during the first two post-operative days after LC. Preoperative somato-visceral or somatic local anesthesia reduced incisional pain during the first three post-operative hours. A combination of somato-visceral local anesthetic treatment did not reduce intraabdominal pain, shoulder pain or nausea more than somatic treatment alone. Preoperative incisional infiltration of local anesthetics is recommended.
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La ventilation non invasive est probablement un des progrès majeurs des dix dernières années dans le traitement de l'insuffisance respiratoire aiguë aux soins intensifs. Son efficacité a été démontrée dans plusieurs indications. ⋯ Comme il demeure toujours possible d'intuber le patient en cas d'échec, la VNI peut être tentée dans plusieurs situations cliniques. Finalement, les succès de la VNI dépendent de l'intérêt et de l'expérience de l'équipe soignante.
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Case Reports
Removal of the connector on the laryngeal mask airway provides a useful alternative to the intubating laryngeal mask.
We describe two cases in which fiberoptic intubation through the standard laryngeal mask airway (LMA) was successful with large-bore tracheal tubes (TTs) when an intubating LMA (ILMA) could not be used. ⋯ A standard LMA whose connector has been removed to allow passage of TTs of >6.0 mm internal diameter may be substituted for the ILMA when necessary.