Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Comparative Study
Performance of the PAxpress vs the ProSeal laryngeal mask airway during general anesthesia.
The PAxpress (PAx) is a relatively new pharyngeal airway device that is easily inserted and effective in routine airway management. A prospective, randomized study was undertaken to compare the PAx with the ProSeal laryngeal mask airway (PLMA) during anesthesia with positive pressure ventilation. ⋯ In comparison with the PLMA, PAx insertion time is longer and the ventilatory characteristics of this new device may be marginally inferior. The PAx is also more traumatic and is associated with more postoperative discomfort compared to the PLMA.
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To review established techniques and to provide an update on new methods for clinical monitoring of neuromuscular function relevant to anesthesia. ⋯ Objective methods should be used to monitor neuromuscular function in clinical anesthesia. Acceleromyography offers the best compromise with respect to ease of use, practicality, versatility, precision and applicability at various muscles. The CS is the optimal muscle to determine the earliest time for intubation, e.g., for rapid sequence induction.
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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.
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We describe a complication of epiduroscopy with encephalopathy and rhabdomyolysis associated with the contrast medium iotrolan. ⋯ Dural tear during epiduroscopy may allow access of contrast media into the CSF. Neurotoxicity secondary to iotrolan within the CSF was a likely contributing factor to the encephalopathy and subsequent rhabdomyolysis. This is an instructive example of the importance of diagnosing inadvertent dural tear during epiduroscopy under iotrolan, for avoidance of adverse events such as encephalopathy and rhabdomyolysis.
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Letter Case Reports
Knotting in peripherally inserted central catheters: more possible mechanisms.