Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Identification of a particular vertebral level by clinical landmark palpation is inaccurate. This study uses ultrasound imaging to assess the vertebral level at which the palpated intercristal line occurs in subjects clinically positioned to receive a neuraxial technique. ⋯ According to ultrasound, the palpated intercristal line falls at the L3-4 interspace, or below, in the majority of subjects positioned for neuraxial block in the sitting position. A palpated intercristal line at L2-3 was more likely in tall and male individuals.
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Randomized Controlled Trial Comparative Study
Spinal mepivacaine with fentanyl for outpatient knee arthroscopy surgery: a randomized controlled trial.
The foremost limitation of local anesthetic solutions for spinal anesthesia in the outpatient setting is prolonged motor blockade and delayed ambulation. The purpose of this study was to determine if the addition of intrathecal fentanyl to low-dose spinal mepivacaine provides adequate anesthesia with shorter duration of functional motor blockade for ambulatory knee surgery compared with spinal mepivacaine alone. ⋯ When compared with 45 mg isobaric mepivacaine 1.5%, an intrathecal dose of 30 mg isobaric mepivacaine 1.5% plus 10 microg fentanyl produces reliable anesthesia, hastens block regression, shortens stay in Phase I recovery, and enables earlier ambulation for patients undergoing unilateral knee arthroscopy (Registration no. NCT00803725).
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Randomized Controlled Trial Comparative Study
Comparison of a single-use GlideScope Cobalt videolaryngoscope with a conventional GlideScope for orotracheal intubation.
This study was conceived to compare the single-use GlideScope Cobalt videolaryngoscope with the conventional GlideScope videolaryngoscope for orotracheal intubation, as judged by time to intubation (TTI) and ease of intubation. ⋯ The GlideScope Cobalt has similar performance characteristics compared with the conventional GlideScope videolaryngoscope when used for orotracheal intubation. The two devices can likely be used interchangeably. (ClinicalTrials.gov number, NCT00459797.).
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Meta Analysis
Preload or coload for spinal anesthesia for elective Cesarean delivery: a meta-analysis.
Hypotension following spinal anesthesia for Cesarean delivery is common. Fluid loading is recommended to prevent hypotension, but preload is often ineffective. In non-pregnant patients, coloading has been shown to better maintain cardiac output after spinal anesthesia. The purpose of this meta-analysis was to determine whether the timing of the fluid infusion, before (preload) or during (coload) induction of spinal anesthesia for Cesarean delivery, influences the incidence of maternal hypotension or neonatal outcome. ⋯ It is unnecessary to delay surgery in order to deliver a preload of fluid. Regardless of the fluid loading strategy, the incidence of maternal hypotension is high. Prophylactic or therapeutic vasopressors may be required in a significant proportion of patients.