Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Comparative Study
Early benefit of preserved cognitive function is not sustained at one-year after cardiac surgery: a longitudinal follow-up of the randomized controlled trial.
Recently, we showed that processing of shed blood with a continuous-flow cell saver during cardiopulmonary bypass resulted in a clinically significant reduction in postoperative cognitive decline (POCD) six weeks after coronary artery bypass graft (CABG) surgery. The current study examined if the early benefit of reduced POCD was sustained in the same patient population at one-year follow-up. ⋯ The short-term preservation of cognitive function in elderly patients using the cell saver management strategy did not translate into a long-term benefit one year after CABG surgery. The presence of progressing cerebrovascular disease may be responsible for the long-term cognitive decline.
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This article is a review of the efficacy and safety of the Laryngeal Mask Airway (LMA) Supreme™ as a stand-alone supraglottic airway during general anesthesia and as a conduit for tracheal intubation. Relevant articles were obtained using MEDLINE (1948-July 2011) and EMBASE (1980-July 2011). Only original studies with adult human patients and published in English were selected. ⋯ The LMA Supreme has been shown to be a safe and efficacious device as a stand-alone supraglottic airway and may also be used as a conduit for tracheal intubation. Further trials are needed to determine the efficacy of the LMA Supreme compared with other supraglottic airways in both elective and emergent airway management situations.
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Case Reports
Continuous spinal anesthesia for Cesarean hysterectomy and massive hemorrhage in a parturient with placenta increta.
We present anesthetic management using a continuous spinal anesthesia (CSA) technique in a patient with placenta increta who underwent elective Cesarean hysterectomy with massive postpartum hemorrhage. ⋯ A CSA technique may be a viable option in the event of inadvertent dural puncture during planned CSE or epidural placement in patients with a reassuring airway undergoing Cesarean delivery. Although a catheter-based neuraxial technique is appropriate for Cesarean hysterectomy for abnormal placentation, conversion to general anesthesia may be required in the event of massive perioperative hemorrhage and fluid resuscitation.