Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Clinical Trial
Apnea during induction of anesthesia with sevoflurane is related to its mode of administration.
The incidence and duration of apnea during sevoflurane anesthesia have not been fully characterized. We hypothesized that sevoflurane at slowly increasing concentrations reduces incidence and shortens the duration of apnea compared to administration of a highly concentrated anesthetic mixture. ⋯ Sevoflurane induces apnea more frequently and for longer duration at a fixed high concentration compared to incremental or decremental-incremental concentrations. Decremental-incremental concentrations offer the additional advantage of a speed of induction similar to that elicited by the 8% concentration.
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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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Case Reports
The Proseal LMA is a useful rescue device during failed rapid sequence intubation: two additional cases.
We report two cases where the ProSeal laryngeal mask airway (PLMA) was successfully used as a rescue device, after failed tracheal intubation, during rapid sequence induction. ⋯ The correctly placed PLMA has potential advantages over the cLMA for airway rescue in the circumstance of failed emergency intubation in a patient with a potentially full stomach. In the two cases reported, the PLMA provided effective rescue of the airway.