Canadian journal of anaesthesia = Journal canadien d'anesthésie
-
To report the case of a patient who experienced failed spinal anesthesia following a psoas compartment block (PCB) and discuss its implications. ⋯ We describe a case of failed spinal anesthesia following a PCB and discuss its implications.
-
To document one centre's experience with a multimodal analgesic approach, with or without low dose intrathecal morphine (ITM), in facilitating "fast-track" recovery in patients undergoing cardiac surgery. ⋯ Multimodal postoperative analgesia allowed for uneventful early extubation and low opioid requirements. Low dose ITM further facilitated early extubation, and reduced postoperative analgesic requirements.
-
Case Reports
Prolonged (more than ten hours) neuromuscular blockade after cardiac surgery: report of two cases.
We examine two cases of prolonged neuromuscular blockade (NMB) after cardiac surgery. To the best of our knowledge, these are the first reported cases of complete paralysis lasting more than ten hours after surgery. ⋯ We should avoid administering large doses of NMB agents, even in the context of planned postoperative ventilation. If NMB is not monitored intraoperatively in patients who are at risk of prolonged NMB, then train-of-four response should be measured in the intensive care unit. Adequate sedation should be provided until proper recovery of neuromuscular function is documented.
-
Review Meta Analysis
Cerebral near-infrared spectroscopy in adult heart surgery: systematic review of its clinical efficacy.
This systematic review is aimed at answering the following questions: 1) Is near-infrared spectroscopy (NIRS) clinically effective in detecting cerebral desaturation during heart surgery? 2) Are these results based on studies with solid methodology? ⋯ The clinical application of NIRS in heart surgery as a brain-monitoring device seems interesting. However, NIRS has to be investigated more rigorously to prove its clinical utility in cardiac surgery.