Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Comment Letter Case Reports
Subdural catheterization and opiate administration in a patient with Harrington rods.
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Randomized Controlled Trial Comparative Study Clinical Trial
Clear fluids three hours before surgery do not affect the gastric fluid contents of children.
This prospective, randomized, single-blind study of 121 healthy children aged 2 to 12 yr investigated the effect of clear fluids on gastric contents. Gastric fluid volume and pH were measured immediately following the induction of general anaesthesia and were not significantly affected by the ingestion of unlimited clear fluids up to three hours preoperatively. ⋯ Gastric fluid volume (ml.kg-1) increased in both the control and study groups as age increased, P less than 0.005. It is concluded that drinking clear fluid up to three hours before scheduled surgery does not have a measurable effect on gastric volume and pH of healthy children of ages 2 to 12 yr.
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The laryngeal mask airway consists of a tubular oropharyngeal airway to the distal end of which is sealed a silicone laryngeal mask with an inflatable rim which provides an airtight seal around the larynx. It provided a clear airway in 238 of 250 elective and emergency non-obstetrical patients for a wide variety of surgical procedures, ranging from minor gynaecological and urological procedures to major abdominal and orthopaedic surgery with either spontaneous respiration or intermittent positive pressure ventilation. ⋯ In ten patients tracheal intubation was required because of airway obstruction or a large gas leak. The LM airway does not require laryngoscopy for its insertion, it relieves the anaesthetist's hands from holding a face-mask, it cannot be misplaced in the oesophagus, and it is well tolerated during emergence from anaesthesia.
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This case report describes intraoperative anaphylaxis occurring in a fourteen-year-old female with spina bifida in which latex surgical gloves were incriminated as the aetiologic agent. The patient was non-atopic but since eight years of age she had developed localized angioedema and urticarial skin reactions on exposure to rubber. She had previously undergone several uneventful surgical procedures. ⋯ Subsequent investigations for allergies demonstrated a strongly positive skin prick test and RAST to latex antigen, with negative results to anaesthetic agents, antibiotics and inhalant allergens. During two later operations prophylaxis consisting of diphenhydramine, ranitidine and hydrocortisone appeared to prevent further reactions. Latex should be considered as a cause of life-threatening intraoperative allergic reactions in patients with a history of rubber allergy or frequent exposure to latex products.