Canadian journal of anaesthesia = Journal canadien d'anesthésie
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To determine the stated practices of clinicians in weaning critically ill adults from invasive ventilation. ⋯ Pressure support and SBTs are common features of weaning in Canadian teaching hospitals. Compared to the published literature, our survey suggests that weaning practices have evolved over time and that practice variation may be greater on an international level compared to a national level.
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Failed conversion of epidural labor analgesia (ELA) to epidural surgical anesthesia (ESA) for intrapartum Cesarean delivery (CD) has been observed in clinical practice. However, spinal anesthesia (SA) in parturients experiencing failed conversion of ELA to ESA has been associated with an increased incidence of serious side effects. In this retrospective cohort analysis, we examined our routine clinical practice of removing the in situ epidural, rather than attempting to convert to ESA, prior to administering SA for intrapartum CD. ⋯ The incidence of serious side effects associated with SA for intrapartum CD following ELA is low and not different compared to SA only.
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Case Reports
Repeated large-volume epidural blood patches for the treatment of spontaneous intracranial hypotension.
Refractory headache from spontaneous intracranial hypotension can be debilitating for patients. This report describes the use of repeated high-volume epidural blood patches to treat this condition. ⋯ The ideal volume of blood injectate to achieve maximal effectiveness for an epidural blood patch is unknown. While many clinicians use a predetermined maximal volume, a volume titrated to patient symptoms is a suggested alternate approach.