Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Comparative Study
Hydrocortisone reduces postoperative shivering following day care knee arthroscopy.
Postoperative shivering is commonly observed in patients after general anesthesia. A double-blind randomized controlled trial was conducted in patients undergoing day care knee arthroscopy to test the hypothesis that a single intraoperative dose of hydrocortisone would prevent or attenuate postoperative shivering. ⋯ This study shows that hydrocortisone (1-2 mg·kg(-1) iv) provides effective prophylaxis against postoperative shivering in patients undergoing day care knee arthroscopy under general anesthesia.
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Perioperative intravenous ketamine may be a useful addition in pain management regimens. Previous systematic reviews have included all methods of ketamine administration, and heterogeneity between studies has been substantial. This study addresses this issue by narrowing the inclusion criteria, using a random effects model, and performing subgroup analysis to determine the specific types of patients, surgery, and clinical indications which may benefit from perioperative ketamine administration. ⋯ Intravenous ketamine is an effective adjunct for postoperative analgesia. Particular benefit was observed in painful procedures, including upper abdominal, thoracic, and major orthopedic surgeries. The analgesic effect of ketamine was independent of the type of intraoperative opioid administered, timing of ketamine administration, and ketamine dose.
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We report a case that involved immediate postoperative respiratory failure necessitating tracheal intubation, which was possibly related to recurarization after sugammadex reversal. ⋯ Shortly after tracheal extubation, an obese patient experienced respiratory failure necessitating tracheal intubation and an additional dose of sugammadex. This occurred despite initial reversal of neuromuscular blockade with an appropriate dose of sugammadex 2 mg·kg(-1) iv given at two responses to TOF stimulation.