Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Case Reports
Airway management in a patient with a cleft palate after pharyngoplasty: a case report.
To describe a practical method of aiding nasotracheal intubation in a cleft palate patient with previous pharyngoplasty using a suction catheter under tactile guidance. Problems of airway management in these patients are also discussed. ⋯ Preoperative determination of the type of pharyngoplasty is essential to understand the anatomy of the patent velopharyngeal port. A history of pharyngeal flap infection, hyponasal voice or upper airway obstruction suggests possible port stenosis. We describe a tactile guided technique that is useful and practical. Use of a flexible suction catheter of small external diameter minimizes the potential for trauma, bleeding and creation of false passages.
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Decreased cardiac chronotropic response in elderly patients along with concomitant ss-blockade may suppress the autonomic responsiveness to surgical stimulation and subsequently obscure episodes of "light anesthesia". ⋯ Atenolol reduces anesthetic requirements but may not modify anesthetic depth indicators in elderly patients.
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The PiCCO System is a relatively new device allowing intermittent cardiac output monitoring by aortic transpulmonary thermodilution technique (Aorta intermittent) and continuous cardiac output monitoring by pulse contour analysis (Aorta continuous). The objective of this study was to assess the level of agreement of Aorta intermittent and Aorta continuous with intermittent (PA intermittent) and continuous cardiac output (PA continuous) measured through a special pulmonary artery catheter (Vigilance System SvO(2)/CCO Monitor) in patients undergoing single- or double-lung transplantation. ⋯ Measurements with the aortic transpulmonary thermodilution technique give continuous and intermittent values that agree with the pulmonary thermodilution method which is still the current clinical standard.
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To determine if the extent of sensory blockade after the intrathecal injection of hypobaric fentanyl (25 micro g) and bupicavaine (2.5 mg) in the sitting position in term parturients is influenced by body habitus. ⋯ Height did not influence the extent of sensory analgesia after initiation of intrathecal labour analgesia using a hypobaric solution injected with the parturient in the sitting position. Weight and BMI were associated with a non-clinically significant increase in the cephalic spread of analgesia, suggesting that dose adjustments based on body habitus in this population are not necessary.
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Letter Randomized Controlled Trial Clinical Trial
Lidocaine or fentanyl applied to the surgical wound during spinal surgery produces potent postoperative analgesia.