Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Clinical Trial
Tramadol 2.5 mg x kg(-1) appears to be the optimal intraoperative loading dose before patient-controlled analgesia.
We previously established that a 5 mg x kg(-1) intraoperative dose can reduce the nausea/vomiting associated with tramadol patient-controlled analgesia (PCA). This study was conducted to identify the most appropriate initial dose to improve the quality of tramadol PCA. ⋯ When considering efficacy and side-effect profile, 2.5 mg x kg(-1) of tramadol is the optimal intraoperative dose of this drug to provide effective postoperative analgesia with minimal sedation.
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Randomized Controlled Trial Comparative Study Clinical Trial
LMA-Classic and LMA-ProSeal are effective alternatives to endotracheal intubation for gynecologic laparoscopy.
To compare the laryngeal mask airways (LMA), LMA-Classic(TM) (LMA-C) and LMA-ProSeal(TM) (PLMA) with the endotracheal tube (ETT) with respect to pulmonary ventilation and gastric distension during gynecologic laparoscopy. ⋯ A correctly placed LMA-C or PLMA is as effective as an ETT for positive pressure ventilation without clinically important gastric distension in non-obese and obese patients.
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Prediction of difficulty in orotracheal intubation (DI) in patients undergoing laryngeal microsurgery should help reduce the morbidity-mortality associated with this clinical situation. To establish a simple score to predict this difficulty, we studied 11 variables and their association with DI in these patients. ⋯ The index we describe is aimed at predicting DI in a very specific population with a high risk of this complication. This index uses a series of variables which may be measured easily during the preoperative period and provides an excellent predictive capacity with a high sensitivity and specificity when the index is > or = 5.
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To investigate whether motor evoked potentials (MEP) to transcranial electrical stimulation under constant blood propofol concentration are affected by the arousing effect of surgical noxious stimuli. ⋯ MEP to the transcranial electrical stimulation under a constant and clinically appropriate blood propofol concentration are not affected by surgical noxious stimuli.
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Continuous interscalene brachial plexus blockade (CIBPB) in a hospital setting can provide excellent surgical conditions and postoperative analgesia for major shoulder surgery. This is a case report of four patients on the efficacy and advantages of CIBPB for postoperative analgesia at home. ⋯ The use of CIBPB for 72 hr in patients undergoing major ambulatory shoulder surgery can result in good analgesia with minimal opioid requirement, cost savings and possibly improvement in outcome measures.