Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial
Contribution of the nasal passage to face mask ventilation: a prospective blinded randomized crossover trial.
Previous studies have shown that the nasal passage plays an important role in manual face mask ventilation, but this has yet to be quantitatively assessed. We conducted a prospective randomized crossover clinical trial to compare the change in pressure-controlled face mask tidal volume with and without nasal airway occlusion. ⋯ Nasal passage obstruction considerably reduces tidal volume achieved during face mask ventilation. In some patients, it may be advantageous to relieve nasal airway obstruction for effective face mask ventilation.
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The accuracy of patient prognostication varies extensively in studies of select populations. Prognostication is an important component of patient selection for elective surgery. This retrospective study assessed patient prognostication prior to elective surgery by comparing the observed with the expected number of deaths in such patients. ⋯ The observed number of deaths within one year of elective surgery is significantly lower than expected, with minimal inter-surgeon variation. These results suggest that patient selection for major elective non-cardiac surgery identified individuals with better than expected survival and whose survival was not adversely influenced by their surgery.
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Good pain control is not a normal part of surgical care in sub-Saharan Africa due to lack of resources. The primary objective of this study was to determine an efficacious dose of subcutaneous ketamine for postoperative pain for use in a future randomized controlled trial. ⋯ Adding subcutaneous ketamine to standard analgesic measures resulted in decreases in postoperative pain scores without serious side effects. These data can be used to inform a randomized controlled trial to compare subcutaneous ketamine plus standard care with placebo plus standard care for reducing postoperative pain.