Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Review Meta Analysis Comparative Study
Patient-controlled versus nurse-controlled analgesia after cardiac surgery--a meta-analysis.
Patient-controlled analgesia (PCA) has been advocated as superior to conventional nurse-controlled analgesia (NCA) with less risk to patients. This systematic review and meta-analysis sought to determine whether PCA improves clinical and resource outcomes when compared with NCA. ⋯ In postcardiac surgical patients, PCA increases cumulative 24 and 48 hr morphine consumption, and improves 48-hr VAS compared with NCA.
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Randomized Controlled Trial Comparative Study
Doxapram shortens recovery following sevoflurane anesthesia.
A randomized, double blind controlled trial was undertaken to investigate the effect of doxapram on recovery times and bispectral index following sevoflurane anesthesia. ⋯ We conclude that doxapram 1 mg.kg(-1) hastens early recovery from sevoflurane anesthesia, and this arousal effect correlates with higher bispectral index values.
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Randomized Controlled Trial Comparative Study
Laryngoscopic evaluation with the Airway Cam.
The Airway Cam is a head-mounted direct laryngoscopy video system which uses a prismatic sighting system that aligns with the operator's line of sight. This study evaluated intra- and inter-observer consistency in laryngoscopy grading comparing direct laryngoscopy to the laryngoscopy grade obtained with the Airway Cam. ⋯ This study validates that the view recorded by the Airway Cam reflects the view of the laryngoscopist. The Airway Cam may introduce an additional level of objectivity into airway management research and teaching.
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Case Reports
Cesarean section in a patient with familial cardiomyopathy and a cardioverter-defibrillator.
To describe the impact of maternal automatic implantable cardioverter-defibrillator (AICD) therapy on pregnancy outcome, and discuss the clinical rationale for regional anesthesia in parturients with AICDs. ⋯ Automatic implantable cardioverter-defibrillators are being utilized more frequently in the obstetric population, and appear compatible with good fetal outcomes. Experience with the anesthetic management of these patients is markedly limited - primarily involving reports of general anesthesia for Cesarean section. Epidural anesthesia, however, offers distinct advantages in this patient population including easy conversion from labour analgesia to surgical anesthesia, preservation of fetal-maternal hemodynamics, prevention of increases in plasma catecholamines due to labour or operative pain, and, finally, possible direct suppression of arrhythmias by pharmacologically-active plasma levels of local anesthetic.