Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Pericardial diseases present unique perioperative considerations for the anesthesiologist. The purpose of this review is to provide a summary of the pertinent issues related to the etiology, diagnosis, pathophysiology, and perioperative management of patients presenting for operative treatment of pericardial disease. ⋯ Patients with acute and chronic pericardial diseases often require the need for surgical intervention. Several unique features of acute tamponade and constrictive pericarditis require careful perioperative consideration. With proper preparation and pre-anesthetic optimization, patients with a variety of pericardial diseases can be safely managed before, during, and after their surgical intervention.
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Case Reports
Continuous lumbar transversus abdominis plane block may spread to supraumbilical dermatomes.
The transversus abdominis plane block is an interfascial block intended to target nerves supplying the abdominal wall. It has been shown to reduce pain and postoperative opioids in abdominal surgeries. We present the case of a high-risk patient in whom bilateral continuous lumbar transversus abdominis plane blocks provided effective postoperative analgesia following infraumbilical midline laparotomy. ⋯ Lumbar transversus abdominis plane blocks with continuous infusions may offer an effective alternative to epidural blockade and systemic opioids in high-risk patients. Additionally, given the extensive somatosensory block, this technique may have an analgesic role following abdominal incisions involving not only the infraumbilical region but also supraumbilical sites.
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The use of ultrasound for central venous catheter (CVC) insertion and regional anesthesia (RA) has been recommended to improve efficacy and patient safety. We conducted a survey to evaluate the degree to which ultrasound use has been adopted into routine practice by anesthesiologists in the province of Ontario, Canada. ⋯ The use of ultrasound is better established in academic than in community anesthesia practice. Anesthesiologists in community practice appear to be adopting ultrasound at a slower pace, which may be explained by lack of equipment and lack of training.
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Factors associated with maternal satisfaction of anesthetic management during labour and delivery are poorly known. The purpose of this study was to assess these factors. ⋯ Maternal satisfaction with anesthesia care is largely determined by the effectiveness and correct performance of the procedure carried from the technical and human point of view. However, other factors such as a good coordination in patient management and the absence of complications also influence maternal satisfaction.