Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Comparative Study Clinical Trial
Remifentanil provides better analgesia than alfentanil during breast biopsy surgery under monitored anesthesia care.
To compare the analgesic effects of remifentanil and alfentanil during breast biopsy under monitored anesthesia care (MAC). ⋯ Remifentanil was a better opioid choice than alfentanil for breast biopsy under MAC at the doses studied, but it did not increase the rapidity in which patients recovered postoperatively.
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Randomized Controlled Trial Comparative Study Clinical Trial
The posterior lumbar plexus (psoas compartment) block and the three-in-one femoral nerve block provide similar postoperative analgesia after total knee replacement.
To compare the efficacy of a continuous posterior lumbar plexus (PSOAS) block to a continuous three-in-one femoral nerve (FEM) block in patients undergoing primary total knee replacement (TKR). ⋯ Both continuous PSOAS block and continuous three-in-one FEM block provided better analgesia than PCA but no differences were seen between the two regional techniques.
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Randomized Controlled Trial Clinical Trial
A risk adapted approach reduces the overall institutional incidence of postoperative nausea and vomiting.
Routine prophylactic antiemetic treatment of surgical patients appears justified only in case of an increased risk of postoperative nausea and vomiting (PONV). The objective of this investigation was to assess the feasibility and efficacy of a dichotomized risk score adapted management of PONV based on ondansetron prophylaxis and treatment with respect to the overall institutional rate of PONV. ⋯ Providing antiemetic prophylaxis with ondansetron to high-risk patients strictly based on a simplified risk score can reduce the overall institutional rate of PONV. However, classifying patients into two groups while using ondansetron as the single antiemetic in the high-risk group appears to be of limited efficacy as the incidence of PONV in high-risk patients is still double that of low-risk patients.
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To present a case of laryngeal damage in an infant caused by a too large and inappropriately designed cuffed tracheal tube. ⋯ The larger than expected tracheal tube with its intra-laryngeal cuff position in a 13-month-old child likely caused mucosal damage and an inflammatory reaction within the larynx resulting in granulation tissue formation and fibrous healing around the tracheal tube.
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To determine, in a subset of children previously reported, if the time of day when adenotonsillectomy for severe obstructive sleep apnea syndrome (OSAS) was performed affected the incidence of postoperative respiratory complications. ⋯ Children with severe OSAS whose surgery is performed in the AM are less likely to desaturate following adenotonsillectomy than children whose surgery is performed in the PM.