Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Our experience with intravenous regional anaesthesia (IVRA) in 1,906 patients over a period of 20 years has confirmed that this technique is safe and effective. IVRA may be used to provide anaesthesia for surgery involving both the upper and lower extremities. The need for supplemental medication is ordinarily minimal, so the technique is particularly suitable for short procedures in an ambulatory surgery centre. ⋯ A specific protocol for avoiding technical error is presented. Significantly, over a period of 20 years, there has not been any mortality or major morbidity. The incidence of adverse reactions was 1.6 per cent and consisted of minor events such as transient dizziness, tinnitus or mild bradycardia.
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We describe a modification of retrograde guided intubation. With the help of a gliding knot fixed around the side hole of the tracheal tube, we use the catheter to pull and guide the tracheal tube down the larynx and trachea. The technique offers several advantages: it is surprisingly fast, relatively atraumatic, easy to perform, and eliminates most causes of failure.
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Needle cricothyrotomy is a safe, relatively easy procedure and has been described to enable pulmonary ventilation for patients in both elective and emergency situations. Conventional IV cannulae are short, thin-walled, and easily kinked and, therefore, do not provide a secure system to jet oxygen into the trachea. The vessel dilators of most 7-9 French introducer kits are firm, pliable, resist kinking, and can be passed easily into the tracheal lumen. We describe our experience with the use of vessel dilator cricothyrotomy to oxygenate and ventilate the lungs of patients in emergency and elective situations.