Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Clinical Trial
Sevoflurane with remifentanil allows rapid tracheal intubation without neuromuscular blocking agents.
After inhalational induction with sevoflurane, we compared the effects of adding remifentanil 1 microg x kg(-1) or remifentanil 2 microg x kg(-1) on conditions for tracheal intubation without neuromuscular blocking agents. ⋯ The addition of remifentanil after sevoflurane induction allows for rapid tracheal intubation without neuromuscular blocking agents. The higher dose of remifentanil results in improved conditions for tracheal intubation but also caused a greater decrease in mean arterial pressure. Tracheal intubation using sevoflurane and remifentanil may be an alternative to traditional tracheal intubation with neuromuscular blocking agents.
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Case Reports
Loss of the airway during tracheostomy: rescue oxygenation and re-establishment of the airway.
To describe loss of the airway during tracheostomy and suggest a method for re-establishment of the airway and providing rescue oxygenation. ⋯ To restore a lost airway during tracheostomy, we recommend that a jet ventilation airway exchange catheter (JVAE) be inserted in the endotracheal tube through a bronchoscope port attachment prior to surgical entry into the trachea. The JVAE will also ensure continued ability to oxygenate the patient.
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Case Reports
Confirmation of internal jugular guide wire position utilizing transesophageal echocardiography.
To describe the utility of transesophageal echocardiography (TEE) in confirmation of correct central line J-wire position. ⋯ The case demonstrates the value of TEE to confirm correct guide wire position prior to insertion of a large bore central venous catheter. TEE visualization of J-wire position avoided repeat attempts at internal jugular cannulation and potential carotid artery puncture.
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To evaluate the effectiveness of short-acting anesthetic drugs and techniques to achieve recovery room bypass criteria after minor surgery in a community hospital environment. ⋯ Not all patients who receive a general anesthetic require admission to a phase I recovery facility. However, the justification for use of more expensive pharmaceuticals to achieve PACU bypass requires extensive changes in operating systems and voluntary professional behaviours.
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To investigate the effect of xenon (Xe) and nitrous oxide (N(2)O) on norepinephrinergic neuronal activity in the rat medial preoptic area (mPOA) and posterior hypothalamus (PH) using microdialysis. ⋯ The present data suggest that Xe stimulates norepinephrinergic neurons more potently than N(2)O; 1.2 times more in the mPOA and 2.5 times more in the PH. This stimulant effect may contribute to the hypnotic and sympathotonic effects of Xe in rats.