Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Case Reports
Laryngo-tracheo-bronchial stenosis in a patient with primary pulmonary amyloidosis: a case report and brief review.
To report a case of lower respiratory tract obstruction occurring in a patient with primary pulmonary amyloidosis and discuss anesthetic management. ⋯ Primary laryngo-tracheo-bronchial amyloidosis is a recurrent disease, requiring repetitive surgical procedures. Airway compromise can be a persistent problem. Awareness of this uncommon disease process and its presentation may serve to caution the anesthesiologist presented with this type of case.
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Case Reports
Total airway obstruction during local anesthesia in a non-sedated patient with a compromised airway.
To report a case of complete upper airway obstruction after topicalization with lidocaine in a completely conscious patient with partial upper airway obstruction. ⋯ Dynamic airflow limitation associated with local anesthesia of the upper airway may lead to complete upper airway obstruction in a compromised airway. The main cause may be the loss of upper airway muscle tone, exacerbated by deep inspiration during panic.
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Clinical Trial Controlled Clinical Trial
Desflurane increases cerebral blood flow velocity when used for rapid emergence from propofol anesthesia in children.
Desflurane may be used to replace propofol at the end of anesthesia to facilitate rapid emergence. This study determined the effect of administering desflurane during emergence of anesthesia on middle cerebral artery blood flow velocity (Vmca) in children anesthetized with propofol. ⋯ Desflurane is associated with an increase in cerebral blood flow velocity when used to facilitate rapid emergence following a propofol infusion in children. This may be of clinical significance in patients with intracranial pathology.
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Perioperative beta-blockade appears to reduce morbidity and mortality in non-cardiac surgery, and is recommended by published guidelines. This study explores the frequency of perioperative beta-blockade and identifies factors limiting its use. ⋯ Use of preoperative beta-blockade among suitable candidates appears to be approximately 40%. Anesthesiologists started preoperative beta-blockers infrequently even in patients without contraindications. These findings suggest that educating anesthesiologists about the perioperative use of beta-blockade may increase the use of this potentially beneficial strategy.