Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Sciatic nerve block in the popliteal fossa (popliteal nerve block, PNB) is an anaesthetic technique well-suited for operations below the knee. However, difficulty with positioning the patient in the prone position often precludes the classical, posterior approach to the block. In this report, an alternative approach to PNB that can easily be performed with a patient in the supine position is described. ⋯ The supine approach to PNB allows the use of the block in patients that cannot be positioned in the prone position. Flexion of the leg at the knee greatly facilitates identification of the anatomical landmarks. When combined with a block of the femoral or saphenous nerve, this technique provides excellent anaesthesia for patients undergoing foot and ankle surgery.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of ondansetron and prochlorperazine for the prevention of nausea and vomiting after tympanoplasty.
To evaluate the effects on PONV and headache after tympanoplasty of prochlorperazine 0.2 mg.kg-1 i.m., ondansetron 0.06 mg.kg-1 i.v. or placebo (isotonic saline) 0.02 ml.kg-1 i.v. given immediately after induction of anaesthesia prior to tracheal intubation. ⋯ Prophylactic prochlorperazine 0.2 mg.kg-1 i.m. and ondansetron 0.06 mg.kg-1 i.v. are similarly efficacious in reducing nausea with vomiting after tympanoplasty, while prochlorperazine 0.1 mg.kg-1 i.v. is less efficacious. Neither drug given as described appeared to reduce the frequency of postoperative nausea alone or vomiting alone.
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This case describes the management of a 19-yr-old wheelchair bound primigravida with severe muscular dystrophy who presented for Caesarean section after spontaneous rupture of membranes. Anaesthesia was influenced by several features of her systemic disease which were impediments to both neuraxial and general anaesthesia. ⋯ This case illustrates the use of epidural anaesthesia in the successful management of a severely compromised patient with limb-girdle muscular dystrophy undergoing elective Caesarean section.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Comparison of sevoflurane/fentanyl and isoflurane/fentanyl during elective coronary artery bypass surgery. Sevoflurane Venture Group.
Due to the progressive aging of the surgical population, the proportion of patients with coronary artery disease (CAD) is likely to increase. The effects of the new inhalational anaesthetic sevoflurane must be determined in patients with known CAD. ⋯ In patients undergoing elective CABG with low risk factors, either sevoflurane or isoflurane, combined with fentanyl, provided an acceptable preCPB haemodynamic profile and cardiac outcomes.
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Randomized Controlled Trial Clinical Trial
Oral clonidine reduces postoperative PCA morphine requirements.
The purpose of this study was to evaluate the effect of perioperative oral clonidine on postoperative analgesia and PCA morphine requirements in adult patients after major orthopaedic knee surgery. ⋯ Oral clonidine is a useful component to postoperative balanced analgesia as it decreases PCA morphine requirements and decreases the incidence of nausea and vomiting.