Canadian journal of anaesthesia = Journal canadien d'anesthésie
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The research productivity was estimated by publications from anesthesiology departments at Canadian universities over a five-year period, and the articles published were classified into several study designs. ⋯ Although overall numbers in anesthesia publications do not suggest a significant decline, the number of RCTs decreased during the years 2000-2004. The quality of anesthesia research appears to be comparable to those in other medical specialties, with larger institutions conducting RCTs and smaller institutions publishing more case reports.
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Inadvertent epidural needle punctures represent the leading cause of severe postdural puncture headache (PDPH) in parturients. Use of small gauge (G) epidural needles for continuous analgesia has received little attention despite possible important reductions in PDPH. We report the first study to examine the feasibility of using small G Tuohy needles and 23 G catheters for labour analgesia. ⋯ It is feasible to provide high quality labour analgesia using small G epidural needles and catheters. The effect of small G epidural needles on PDPH warrants future study.
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Obesity is a common comorbid condition among patients undergoing coronary bypass surgery. Previous studies have shown inconsistent results as to whether obese patients require prolonged ventilation after cardiac surgery. Fast track recovery strategies have become common to reduce the duration of ventilation and intensive care. The purpose of this study was to determine whether, in our practice, obesity affects post-operative ventilation time using a fast track recovery strategy. ⋯ While most obese patients can undergo a fast track recovery strategy following cardiac surgery, in our institution the incidence of failure of early extubation is significantly higher than in non-obese patients. Our experience may assist in resource planning for postcardiac surgery patients.
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Noonan syndrome is a relatively uncommon genetic disorder with implications for anesthesia due to multiple organ system involvement. Pregnancy presents additional concerns and there are only four reported cases of anesthesia for Cesarean delivery in parturients with Noonan syndrome. We describe the first reported management of labour analgesia in a parturient with Noonan syndrome culminating in vaginal delivery. ⋯ Parturients with Noonan syndrome can present with an array of anomalies that may present difficulties to the anesthesiologist including a difficult airway, cardiopulmonary abnormalities, exaggerated lumbar lordosis and short stature. Careful preoperative consultation and determination of the degree of associated anomalies will help to prepare the anesthesiologist for potential problems.
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It has been shown that airway ciliary function is impaired by several anesthetic or sedative drugs, which may predispose anesthetized or intensive care patients to respiratory complications, such as hypoxemia, atelectasis and pulmonary infection. We studied the effects of midazolam, propofol, dexmedetomidine, ketamine, fentanyl, thiopental and pentobarbital on ciliary beat frequency (CBF) in isolated and cultured rat tracheal epithelial (RTE) cells, to investigate their direct CBF action removing influences of non-epithelial cells. ⋯ These results show that midazolam, propofol, dexmedetomidine and thiopental have no direct action on CBF in isolated RTE cells, whereas high doses of ketamine and fentanyl have direct ciliostimulatory actions and pentobarbital has a direct cilioinhibitory action.