Canadian journal of anaesthesia = Journal canadien d'anesthésie
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To determine inter-observer reliability of ten preoperative airway assessment tests used for predicting difficult tracheal intubation. ⋯ Many of the preoperative airway tests have only moderate inter-observer reliability. This may provide some insight into why previous research has failed to show that the tests accurately predict difficult tracheal intubation.
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Case Reports
Left superior vena cava: a vascular abnormality discovered following pulmonary artery catheterization.
This report deals with the case of a patient who presented persistence of left superior vena cava (LSVC). This disorder was discovered following placement of a catheter in pulmonary artery via the left subclavian vein. ⋯ A diagnosis of persistent LSVC should be considered whenever there appears to be some obstacle to central venous or pulmonary artery catheterization, especially in patients with congenital heart disease, since this disorder can have important clinical consequences.
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Case Reports
Failure of neuromuscular blockade reversal after rocuronium in a patient who received oral neomycin.
Because the aminoglycoside antibiotics and nondepolarizing muscle relaxants have interactions that vary, it is necessary to update the potential for such interactions when new drugs are introduced clinically. Rocuronium is a newly released steroidal nondepolarizing muscle relaxant with an intermediate duration of action. The following report is the first description of prolonged neuromuscular blockage after rocuronium in a patient who had received oral neomycin in anticipation of open bowel resection. ⋯ Rocuronium, a new nondepolarizing muscle relaxant, has potential interactions with other drugs including the aminoglycoside antibiotics. This clinical report describes the failure of neuromuscular blockade reversal in a patient who received oral neomycin in anticipation of open bowel resection.
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Sleep apnoea syndrome (SAS) is a relatively common, potentially fatal, disorder. Patients with SAS exhibit repetitive, often prolonged episodes of apnoea during sleep, with serious nocturnal and diurnal physiologic derangements. Several anecdotal reports and clinical studies have documented anaesthetic-related occurrence of fatal and near-fatal respiratory complications in these patients. The purpose of this article is to outline the potential problems encountered in anaesthetic management of adult SAS patients, and to suggest a practical approach for anaesthesia both for incidental and specific procedures. ⋯ Perioperative risks attending SAS patients emphasize the importance of their detection, perioperative evaluation and planning.