Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Clinical Trial
Lidocaine tape relieves pain due to needle insertion during stellate ganglion block.
To investigate the efficacy of lidocaine tape, a new preparation of lidocaine for cutaneous topical anaesthesia in the form of a self-adhesive tape, in alleviating the pain of needle insertion during stellate ganglion block. ⋯ Stellate ganglion block without analgesia is fairly painful in some patients, even when using a 24-gauge needle, and needle pain is reduced by lidocaine tape after an application time of seven minutes or more.
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We report a case of postoperative reparalysis in the recovery room, following nebulized epinephrine. The patient was pharmacologically reversed with edrophonium after paralysis with rocuronium. ⋯ Postoperative reparalysis following rocuronium may be a cause of postoperative respiratory distress. The definitive diagnosis is made using PNS and observing the response to pharmacological reversal. Nebulized epinephrine may have a previously undescribed role in the development of postoperative reparalysis.
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Cardiac perforation is a recognised complication of guidewire-introducer techniques. These two new cases of right ventricular perforation implicate the dilator-introducer: one directly and the other due to presumed guidewire buckling. ⋯ These cases suggest that shorter introducer-dilators would be safer and probably equally efficacious. The need for a high index of suspicion and rapid therapeutic intervention is also highlighted.
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To quantify gastric fluid volumes in infants with pyloric stenosis presenting for pyloromyotomy and to demonstrate endoscopically the efficacy of blind aspiration for gastric fluid recovery. We hypothesized that previous diagnostic contrast studies, preoperative nasogastric suction, and fasting interval would not affect these volumes. ⋯ Infants with pyloric stenosis have large gastric fluid volumes which are not substantially reduced by preoperative nasogastric suction. Blind aspiration of gastric contents prior to induction of anaesthesia provides a reliable estimate of total gastric fluid for most of these infants, although the occasional infant may retain a small amount of gastric fluid. The clinical importance of such a residual volume is uncertain.
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To evaluate tapes and taping methods with respect to the minimum force required to dislodge endotracheal tubes (ETTs). ⋯ There are differences in ETT pullout forces and mechanisms of dislodgement depending on taping method and tape type.