Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Letter Case Reports
Knotting in peripherally inserted central catheters: more possible mechanisms.
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Randomized Controlled Trial
Intrathecal plain vs hyperbaric bupivacaine for labour analgesia: efficacy and side effects.
Baricity is an important determinant of block characteristics of the spinal component of a combined spinal epidural (CSE) for labour analgesia. This study compares the analgesic efficacy and side effects of intrathecally administered plain and hyperbaric bupivacaine (both with fentanyl) during active labour. ⋯ A plain rather than hyperbaric solution of bupivacaine 2.5 mg with fentanyl 15 microg provides a faster onset of analgesia, higher sensory levels and less motor block, while demonstrating an increased incidence of pruritus and sustained fetal bradycardia.
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Randomized Controlled Trial
Effect of stylet angulation and endotracheal tube camber on time to intubation with the GlideScope.
The GlideScope videolaryngoscope usually provides excellent glottic visualization, but directing an endotracheal tube (ETT) through the vocal cords is sometimes difficult. The goal of the study was to determine which of two ETT angles (60 degrees vs 90 degrees ) and cambers (forward vs reverse) was better, as determined by time to intubation (TTI). ⋯ In a heterogeneous group of operators and patients intubated with the GlideScope, a 90 degrees ETT angle provided the best result and should be the initial configuration. The camber of the ETT does not affect the time to intubation.
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Postoperative hypothermia after cardiac surgery is still a common problem often treated with forced-air warming. This study was conducted to determine the heat transfer efficacy of 11 forced-air warming systems with full body blankets on a validated copper manikin. ⋯ There are clinically relevant differences between the tested forced-air warming systems with full body blankets. Several systems were unable to transfer heat to the manikin at a surface temperature of 38 degrees C.
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Two cases are presented wherein the GlideScope videolaryngoscope (GVL) facilitated laryngeal exposure and successful endotracheal intubation, but resulted in pharyngeal injury. ⋯ There have been no previously published reports of injuries related to GlideScope laryngoscopy, but perforation of the palatopharyngeal arch occurring in two patients demonstrates a rare but potentially important complication of the GVL. Strategies to minimize this complication are considered.