Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Benzodiazepines are commonly administered during cardiac surgery because of their limited effect on hemodynamics and presumed role in preventing intraoperative awareness. Recent concerns about an increased risk of delirium with benzodiazepines have resulted in decreased usage in the intensive care unit and in geriatric perioperative practice. Little is known, however, about current benzodiazepine usage in the setting of adult cardiac surgery. ⋯ Benzodiazepine use is common among academic cardiac anesthesiologists in Canada. Nonetheless, heterogeneity exists between individual practices, suggesting clinical equipoise between restrictive and liberal administration of benzodiazepines for cardiac anesthesia. L'administration de benzodiazépines pendant la chirurgie cardiaque chez l'adulte: évaluation de la pratique actuelle des anesthésiologistes canadiens exerçant en milieu universitaire.
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Review Meta Analysis Comparative Study
Equivalent analgesic effectiveness between perineural and intravenous dexamethasone as adjuvants for peripheral nerve blockade: a systematic review and meta-analysis.
Dexamethasone is commonly used as an adjuvant to local anesthetics for peripheral nerve blockade; however, uncertainty persists regarding its optimal route of administration and safety. A systematic review and meta-analysis of randomized-controlled trials (RCTs) was conducted to compare the incremental benefits of intravenous (IV) vs perineural (PN) dexamethasone when used as adjuvants for peripheral nerve blockade to improve analgesia. ⋯ The results of our meta-analysis suggest that PN and IV dexamethasone provide equivalent analgesic benefits and have similar safety profiles, when used as adjuvants, for peripheral nerve blockade.
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Randomized Controlled Trial Comparative Study
Nitrous oxide added at the end of isoflurane anesthesia hastens early recovery without increasing the risk for postoperative nausea and vomiting: a randomized clinical trial.
Nitrous oxide (N2O) has been reported to increase the risk of postoperative nausea and vomiting (PONV) in a dose-dependent manner. We investigated the effect of adding N2O at the end of isoflurane inhalational anesthesia on the recovery and incidence of PONV. Our hypothesis was that N2O would reduce the time to early recovery without increasing the incidence of PONV. ⋯ Adding N2O during the last 30 min of an isoflurane-based inhalational anesthetic reduced the time to extubation, eye opening, and orientation.
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Randomized Controlled Trial
Subcutaneous ketamine for postoperative pain relief in Rwanda: a randomized clinical trial.
Postoperative pain control is often inadequate in low-income countries such as Rwanda, prompting the search for an inexpensive improvement. A randomized controlled trial was conducted to study the use of subcutaneous ketamine for the management of postoperative pain in patients undergoing major surgery in Kigali, Rwanda. ⋯ Results of this study in Kigali, Rwanda showed that subcutaneous administration of ketamine 1 mg·kg-1 twice daily, in addition to standard postoperative care, produced a small improvement in postoperative pain but resulted in more minor side effects TRIAL REGISTRATION: www.clinicaltrials.gov (NCT02514122). Registered 31 July 2015.