Canadian journal of anaesthesia = Journal canadien d'anesthésie
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To describe a case of vomiting with a laryngeal mask airway ProSeal(TM) (PLMA) in situ. The new design features of the PLMA and their role in protection from aspiration are discussed. ⋯ This case provides evidence that the drain tube of the PLMA directs vomitus away from the airway when properly positioned and may have prevented aspiration in an anesthetized patient.
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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 establish the appropriate inhalation induction technique using a high concentration of sevoflurane in the elderly. ⋯ Our results suggest that a high concentration sevoflurane induction using a gradual reduction technique may be an acceptable alternative to standard iv induction in elderly patients.
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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.