Canadian journal of anaesthesia = Journal canadien d'anesthésie
-
Comparative Study
Laboratory investigation: effects of propofol on the systemic inflammatory response during aortic surgery.
A laboratory investigation was undertaken to assess the effects of propofol on renal function, through modulation of the systemic inflammatory response, in an in vivo experimental model of aortic surgery in comparison with sevoflurane. ⋯ In an experimental model of aortic reconstructive surgery, and compared with sevoflurane, propofol anesthesia is associated with less neutrophil infiltration, lower plasma proinflammatory cytokine levels, lower production of oxygen free radicals, less lipid peroxidation, and reduced inducible nitric oxide synthase activity. These observations suggest a possible renal protective effect of propofol in this surgical setting.
-
Randomized Controlled Trial
Intraoperative infusion of dexmedetomidine reduces perioperative analgesic requirements.
This prospective, randomized, double-blind study was designed to assess whether intraoperative infusion of dexmedetomidine provides effective postoperative analgesia. Postoperative pain scores and morphine consumption were compared in a treated group and a placebo group, both of which received patient-controlled morphine after total abdominal hysterectomy. ⋯ Continuous iv dexmedetomidine during abdominal surgery provides effective postoperative analgesia, and reduces postoperative morphine requirements without increasing the incidence of side effects.
-
Labetalol is an effective antihypertensive medication frequently used to treat systemic hypertension in acute care settings, including the management of hypertension associated with a subarachnoid hemorrhage. We present a case of profound hypotension, refractory to inotropic and vasopressor therapy following an iv infusion of labetalol. ⋯ The episode of profound hypotension which occurred after initiating a labetolol infusion required maximal combined vasopressor therapy to restore the blood pressure suggesting that this patient demonstrated an extreme sensitivity to labetalol. Combination therapy with adrenergic and nonadrenergic agonists may be required for optimal treatment of profound hypotension associated with labetalol-induced vasoplegia.
-
Randomized Controlled Trial Comparative Study
Pain relief and functional status after vaginal hysterectomy: intrathecal versus general anesthesia.
We tested the hypothesis that the use of subarachnoid block (SAB) for vaginal hysterectomy produces superior postoperative analgesia and improves functional status at 12 weeks postoperatively. ⋯ A significantly better immediate postoperative analgesia was present in the SAB group, and the duration was consistent with the expected action of intrathecally administered drugs. Two weeks after surgery a higher percentage of the patients in the SAB group reported no pain. However, SAB had no effect on either length of hospitalization or patients' postoperative functional status.
-
Comparative organ donation rates are expressed per million population and by this measurement, Canada lags behind other countries. These estimates do not account for differing demographics and health patterns of populations which can result in different rates of death by neurological criteria and subsequent donation rates. We sought to measure directly the number of deaths by neurological criteria, the associated donation rates, and the reasons for the differences. ⋯ There is substantial geographic variability in the rate of neurological death and actual organ donation rates in these Canadian tertiary care centres. These variations are principally related to regional differences in demographics of brain injury, referral patterns and donation consent rates, rather than lack of identification of potential donors.