Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Comparative Study Clinical Trial
Phonomyographic measurements of neuromuscular blockade are similar to mechanomyography for hand muscles.
Phonomyography consists of recording low frequency sounds created during muscle contraction. In this study, phonomyography of three regions of the hand was compared to mechanomyography of the adductor pollicis. ⋯ There was good agreement between mechanomyographic measurements at the adductor pollicis muscle and phonomyographic measurements at the thenar and the first dorsal interosseus muscles. Phonomyography of those two muscles could be used interchangeably with mechanomyography of adductor pollicis for clinical purposes.
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Regional anesthesia can be the technique of choice for selected ambulatory surgery procedures, but in spite of its benefits, it has an inherent failure rate even in experienced hands. We examine the efficacy and factors associated with failure of ambulatory regional anesthesia techniques. ⋯ High BMI and ASA IV are independent risk factors for block failure in ambulatory surgery patients.
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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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Bilateral sixth nerve palsy is a known though uncommon complication following dural puncture. The recommended treatment consists of hydration and alternate monocular occlusion. The value and the timing of an epidural blood patch (EBP) for sixth nerve palsy remains controversial as some authors have demonstrated benefits in performing an EBP early in course of the nerve palsy whereas others have not found any advantage when an EBP was performed later. ⋯ Blood patching within 24 hr of the onset of diplopia may be a reasonable treatment for ocular nerve palsy as it relieved the postdural puncture headache and produced partial improvement of the diplopia.