Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Comparative Study
Simple changes can improve conduct of end-of-life care in the intensive care unit.
To describe changes to the conduct of withdrawal of life support (WOLS) in two teaching hospital tertiary care medical surgical intensive care units (ICUs) in a single centre over two distinct time periods. ⋯ Simple changes to the process of WOLS can improve conduct of end-of-life care in the ICU.
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Comparative Study
Encapsulation of mepivacaine prolongs the analgesia provided by sciatic nerve blockade in mice.
Liposomal formulations of local anesthetics (LA) are able to control drug-delivery in biological systems, prolonging their anesthetic effect. This study aimed to prepare, characterize and evaluate in vivo drug-delivery systems, composed of large unilamellar liposomes (LUV), for bupivacaine (BVC) and mepivacaine (MVC). ⋯ MVC(LUV) provided a LA effect comparable to that of BVC. We propose MVC(LUV) drug delivery as a potentially new therapeutic option for the treatment of acute pain since the formulation enhances the duration of sensory blockade at lower concentrations than those of plain MVC.
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Randomized Controlled Trial Comparative Study Clinical Trial
Automated intermittent epidural boluses improve analgesia induced by intrathecal fentanyl during labour.
We compared the efficacy of epidural continual intermittent boluses (CIB) with a continuous epidural infusion (CEI) in prolonging labour analgesia induced by the combined spinal epidural (CSE) technique. ⋯ CIB prolonged the duration and improved the quality of analgesia. CIB could have resulted in an improved spread of analgesics in the epidural space or encouraged a direct passage of infusate into the IT space. This could have also rendered a higher sensory block to cold in the CIB group. CIB is a good alternative to CEI for the maintenance of epidural analgesia after CSE.
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To review the effects of maternal anesthesia and analgesia on the fetus and newborn. ⋯ The well-being of the infant is a major criterion for evaluating the anesthetic management of pregnant women. Many tools exist to assist with this determination for the fetus, whereas few are available to evaluate the newborn.