Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Clinical Trial
Ketorolac analgesia for inguinal hernia repair is not improved by peripheral administration.
It has been suggested that ketorolac, a non-steroidal anti-inflammatory drug (NSAID) available for parenteral use, may result in prolonged (24 hr) postoperative analgesia through a peripheral mechanism when added to local anesthetic infiltration. Our objective was to assess this effect by controlling for systemic absorption of the drug. ⋯ Adding ketorolac to lidocaine infiltration for hernia repair does not improve or prolong postoperative analgesia compared to systemic administration.
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Randomized Controlled Trial Comparative Study Clinical Trial
Mechanism of injection pain with long and long-medium chain triglyceride emulsive propofol.
t has been suggested that long-medium chain triglyceride (LCT/MCT) emulsive propofol causes less injection pain than long chain triglyceride (LCT) emulsive propofol because of the decreased propofol concentration in the aqueous phase. Alternatively, LCT propofol generates bradykinin causing the injection pain and activates complement, but these effects when using LCT/MCT propofol have not been examined. To identify the mechanism for reduced pain with LCT/MCT propofol, injection pain, bradykinin generation and complement activation with use of both propofol products were compared. ⋯ LCT/MCT propofol causes less pain on injection compared with LCT propofol. Bradykinin generation and complement activation are similar with both LCT and LCT/MCT propofol. Thus, the reason for less pain on injection with LCT/MCT propofol may be attributed to a decreased concentration of propofol in the aqueous phase.
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Randomized Controlled Trial Comparative Study Clinical Trial
The LMA Fastrach facilitates fibreoptic intubation in oral cancer patients.
To compare ease of endotracheal intubation with the Intubating Laryngeal Mask Airway (ILMA) tracheal tube (TT; for LMA-Fastrach) and regular PVC TT (Portex) for nasotracheal fibreoptic intubation in oral cancer patients with a difficult airway. ⋯ Use of a soft, flexible, nonkinking ILMA TT with a tapered tip design facilitates passage into the trachea over a fibreoptic bronchoscope and allows maintenance of lower airway pressures. The ILMA TT may be a useful adjunct for management of the difficult airway in oral cancer surgery.
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Multicenter Study
Transfusion rates vary significantly amongst Canadian medical centres.
To document variation of transfusion practice following repair of hip fracture or cardiac surgery, as well as those requiring intensive care following a surgical intervention or multiple trauma (high risk patients). ⋯ We noted significant differences in the rates of red cell transfusion and nadir hemoglobin concentrations in various surgical and critical care settings.
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Case Reports
Selective ordering of preoperative investigations by anesthesiologists reduces the number and cost of tests.
Preoperative investigations are frequently ordered according to care maps or protocols. We hypothesized that selective ordering of investigations by anesthesiology staff would reduce the number and cost of testing. ⋯ Selective test ordering by staff anesthesiologists reduces the number and cost of preoperative investigations. Educational efforts should be directed towards improving resident and staff preoperative test ordering practices.