Canadian journal of anaesthesia = Journal canadien d'anesthésie
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To identify and characterize the evidence supporting decisions made in the care of patients with selected medical conditions undergoing ambulatory anesthesia and surgery. Conditions highlighted in this review include: the elderly, heart transplantation, hyper-reactive airway disease, coronary artery disease, and obstructive sleep apnea. ⋯ Ambulatory anesthesia is infrequently associated with adverse outcomes, however, knowledge regarding specific patient conditions is of generally low quality. Few prospective trials are available to guide management decisions.
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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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Comparative Study
In cadavers, directly measured mucosal pressures are similar for the Unique and the Soft Seal laryngeal mask airway devices.
We compare the Soft Seal and Unique single-use, plastic laryngeal mask airway devices with respect to intracuff pressure, directly measured mucosal pressure and in vitro elastance. ⋯ Intracuff pressures and in vitro elastance are higher for the Unique than the Soft Seal, but mucosal pressures are similar suggesting that the airway morbidity will be similar.
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Sciatic nerve blocks through lateral approaches in the popliteal fossa have been proposed. We describe a new medial approach to the sciatic nerve at this level. ⋯ We describe a new medial approach to the sciatic nerve in the popliteal fossa. More studies will be required to demonstrate the technique is effective and safe.