Canadian journal of anaesthesia = Journal canadien d'anesthésie
-
A number of original publications and review articles have addressed the issue of perioperative immune modulation and cancer outcome. The objective of this module is to review current understanding surrounding the pathways involved and the evidence implicating commonly used anesthetic agents. ⋯ Recommendations for a specific anesthetic technique based on cancer outcome alone cannot be made. A pragmatic solution would be to offer regional anesthesia in isolation or combined with propofol infusion to cancer patients if appropriate and if local expertise is available. Regional anesthesia offers excellent analgesia, a low incidence of postoperative nausea and vomiting, and a favourable immunological profile based on current understanding of laboratory evidence.
-
Perioperative hypothermia is still a common occurrence, and it can be difficult to measure a patient's core temperature accurately, especially during regional anesthesia, with placement of a laryngeal mask airway device, or postoperatively. We evaluated a new disposable double-sensor thermometer and compared the resulting temperatures with those of a distal esophageal thermometer and a bladder thermometer in patients undergoing general and regional anesthesia, respectively. Furthermore, we compared the accuracy of the thermometer between regional and general anesthesia, since forehead microcirculation might differ between the two types of anesthesia. ⋯ In a perioperative patient population undergoing general or regional anesthesia, the accuracy of the noninvasive disposable double-sensor thermometer is comparable with that of the distal esophageal and bladder thermometers in routine clinical practice. Furthermore, the sensor performed comparably in patients undergoing regional and general anesthesia.