Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Letter Case Reports
Difficult ventilation in a wide congenital tracheoesophageal fistula.
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Case Reports
Alternative site for median nerve blockade allowing early functional rehabilitation after hand surgery.
In this report we describe an alternative approach to catheter placement for continuous selective median nerve blockade. It spared the finger movements and therefore allowed early postoperative rehabilitation in a patient who underwent surgical repair of the index finger flexor tendon. ⋯ Placement of a catheter for continuous median nerve blockade in the proximal one-third of the forearm for effective postoperative pain-free rehabilitation after hand surgery should be considered in cases in which the surgical incision extends toward the patient's wrist. The block site can be readily identified by a combined use of ultrasonography and neurostimulation guidance.
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Seizures after cardiac surgery are a serious complication. The antifibrinolytic agent tranexamic acid (TA), which has known proconvulsant properties, may be associated with postoperative seizures. We sought to determine the association between TA and other risk factors for seizures after cardiac surgery. ⋯ Our data suggest that multiple risk factors, including TA, are associated with seizures after cardiac surgery. Thus, the TA dose may be a readily modifiable risk factor for postoperative seizures.
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Practice Guideline
Guidelines to the Practice of Anesthesia Revised Edition 2012.
The Guidelines to the Practice of Anesthesia Revised Edition 2012 (the guidelines) were prepared by the Canadian Anesthesiologists' Society (CAS), which reserves the right to determine their publication and distribution. Because the guidelines are subject to revision, updated versions are published annually. Whereas previous versions of the guidelines appeared as special supplements to the Canadian Journal of Anesthesia (the Journal), this edition of the guidelines is published within the Journal. ⋯ Although the CAS encourages Canadian anesthesiologists to adhere to its practice guidelines to ensure high-quality patient care, the society cannot guarantee any specific patient outcome. Each anesthesiologist should exercise his or her own professional judgement in determining the proper course of action for any patient's circumstances. The CAS assumes no responsibility or liability for any error or omission arising from the use of any information contained in its Guidelines to the Practice of Anesthesia.
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Case Reports
Extubation of a difficult airway after thyroidectomy: use of a flexible bronchoscope via the LMA-Classic™.
We report an extubation strategy for a patient scheduled for thyroidectomy who had several factors indicating that it would be a difficult extubation. ⋯ We describe a viable extubation strategy used in a patient after complex thyroid surgery involving tracheal resection. By using the LMA-Classic™ as a bridging device and to facilitate bronchoscopic examination, we were able to address the above concerns and safely manage the extubation phase in this patient.