Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Sciatic nerve block is useful for surgery below the knee both intra- and postoperatively. Several techniques to insert a catheter at the knee level or higher have been described but need mobilization (lateral decubitus) of the patient. We describe novel landmarks, using a high lateral approach, to block the sciatic nerve without moving the patient. ⋯ The lateral technique for sciatic nerve anesthesia and catheter insertion allows patients to remain in the supine position for performance of the block and catheter insertion, and results in a high rate of homogeneous anesthesia and a low incidence of side effects.
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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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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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Case Reports
Fentanyl-induced rigidity during emergence from general anesthesia potentiated by venlafexine.
To present and discuss a case of opioid-induced rigidity with low-dose fentanyl during recovery from anesthesia. ⋯ We observed an atypical case of opioid-induced rigidity in contrast to the classical syndrome, which presents at induction with high-dose opioids. This syndrome has many clinical presentations with neurologic and ventilatory signs of varying intensity. Early recognition of the syndrome and adequate treatment is crucial. If treated adequately, opioid-induced rigidity is self-limited with few complications.
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To assess the dose-dependent effect of low concentrations of isoflurane on respiratory mechanics in normal subjects. ⋯ Isoflurane concentrations between 0.6-1.2% are not associated to a dose-dependent effect on respiratory mechanics.