Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Multicenter Study Comparative Study
Clevidipine compared with nitroglycerin for blood pressure control in coronary artery bypass grafting: a randomized double-blind study.
We tested the hypothesis that clevidipine, a rapidly acting dihydropyridine calcium channel blocker, is not inferior to nitroglycerin (NTG) in controlling blood pressure before cardiopulmonary bypass (CPB) during coronary artery bypass grafting (CABG). ⋯ During CABG, clevidipine was not inferior to NTG for blood pressure control pre-bypass.
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Randomized Controlled Trial
A styletted tracheal tube with a posterior-facing bevel reduces epistaxis during nasal intubation: a randomized trial.
Epistaxis is a common complication of nasal intubation. Ease of insertion of the tracheal tube may be influenced by bevel orientation and tip bending. We examined ease of insertion and epistaxis with two tubes with different orientations and with or without a stylet to modify tip bending. ⋯ UMIN Clinical Trials Registry (UMIN-CTR), UMIN000011327.
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Observational Study
An observational cohort study to assess glycosylated hemoglobin screening for elective surgical patients.
Uncontrolled blood glucose is associated with a higher incidence of surgical site infections, greater utilization of resources, and increased mortality. Preoperative screening for diabetes in elective surgical patients is not routinely performed. The purpose of this study was to examine blood glucose control in a preoperative surgical population. ⋯ Many elective surgical patients are at risk for unrecognized postoperative hyperglycemia and associated adverse outcomes. Random blood sugar testing has limited value and HbA1c may be a more appropriate test for the preoperative assessment of diabetic patients.
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When exposed in the perioperative period to blood components containing immunoglobulin (Ig)A IgA-sensitized IgA-deficient patients are at an increased risk of transfusion-associated anaphylaxis. We present the case of an IgA-deficient patient whose candidacy for double-lung transplantation was under review in the preoperative period. ⋯ Through a multidisciplinary approach [corrected], a successful transplantation outcome was achieved in an IgA-deficient patient undergoing major surgery. Strategies to mitigate risk include the procurement and transfusion of IgA-deficient components, which may be challenging or untenable in emergent perioperative settings.
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Whenever possible, neuraxial anesthesia is the preferred technique for Cesarean delivery; however, under certain circumstances, general anesthesia remains the most appropriate choice. The purpose of this Continuing Professional Development module is to review the key issues regarding general anesthesia for Cesarean delivery. ⋯ A general anesthetic for Cesarean delivery should be based on the following principles: preventing aspiration, anticipating a difficult intubation, maintaining oxygenation, insuring materno-feto-placental perfusion and maintaining a deep level of anesthesia to avoid intraoperative awareness while minimizing neonatal effects.