Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Comparative Study
Advantages of ProSeal and SLIPA airways over tracheal tubes for gynecological laparoscopies.
To compare the efficacy of the ProSeal LMA and SLIPA supralaryngeal airways (SLA) with the standard tracheal tube (TT) in 150 consecutive day-case laparoscopic gynecological surgery procedures requiring general anesthesia. ⋯ These results suggest that the ProSeal LMA (reusable) and SLIPA (single-use) SLAs were easy to use without requiring muscle relaxants, and reduce operating room time compared to the TT technique in day case laparoscopies.
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Case Reports
Extraluminal use of the Arndt pediatric endobronchial blocker in an infant: a case report.
Attaining lung isolation in the infant undergoing thoracic anesthesia can be challenging for the anesthesiologist. We describe a novel approach to performing lung isolation in an infant undergoing thoracotomy for lobectomy using an Arndt pediatric endobronchial blocker via an extraluminal technique. ⋯ This novel technique may provide an easier and more reliable method of attaining single lung ventilation in infants and small children.
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We report an unusual case of upper airway compromise in a patient with Graves' disease. We speculate that this complication may be due, in part, to poorly controlled hyperthyroidism. ⋯ Uncontrolled hyperthyroid patients with large goiters secondary to Graves' disease may develop edema of the upper airway. A high degree of vigilance for airway obstruction is necessary, with a carefully planned approach at each stage of the patient's hospital course to treat this potentially life-threatening situation.
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Randomized Controlled Trial
Lack of a pre-emptive effect of low-dose ketamine on postoperative pain following oral surgery.
The aim of this study was to assess the effect of pre- vs postincisional low-dose iv ketamine on postoperative pain in outpatients scheduled for oral surgery under general anesthesia. ⋯ There was no benefit to pre-emptive administration of ketamine 300 microg x kg(-1) iv whether administered pre- or postoperatively.
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Administration of isoflurane during early reperfusion after prolonged coronary artery occlusion decreases myocardial infarct size by activating phosphatidylinositol-3-kinase (PI3K) signal transduction. The extracellular signal-related kinases (Erk1/2) represent a redundant mechanism by which signaling elements downstream from PI3K, including 70-kDA ribosomal protein s6 kinase (p70s6K) and endothelial nitric oxide synthase (eNOS), may be activated to reduce reperfusion injury. We tested the hypothesis Erk1/2, p70s6K, and eNOS mediate isoflurane-induced postconditioning in rabbit myocardium in vivo. ⋯ The results suggest that the protective effects of isoflurane against infarction during early reperfusion are mediated by Erk1/2, p70s6K, and eNOS in vivo.