Canadian journal of anaesthesia = Journal canadien d'anesthésie
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The authors report a case of bilateral subdural hematoma (SDH) which occurred following epidural analgesia for labour, complicated by post dural puncture headache (PDPH). Physiopathological mechanisms are discussed. ⋯ The presence of PDPH complicated by a typical neurological deterioration should prompt the anaesthetist to seek an immediate clinical and x-ray diagnosis in order to look for the existence of intracranial complications.
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Randomized Controlled Trial Clinical Trial
[Assessment of intubation time and conditions under the influence of rocuronium].
To evaluate the tracheal intubating conditions when intubation time is determined by the onset time of the neuromuscular block either of the adductor pollicis (AP) or of the orbicularis oculi muscle (OO). ⋯ Monitoring neuro-muscular activity of the AP using TOF to determine the appropriate tracheal intubation time and conditions in patients paralysed with rocurorium is more clinically relevant than monitoring the OO muscle.
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Randomized Controlled Trial Clinical Trial
Re-evaluation of i.m. ephedrine as prophylaxis against hypotension associated with spinal anaesthesia for Caesarean section.
To assess the safety and efficacy of 37.5 mg ephedrine i.m. in preventing hypotension associated with spinal anaesthesia for Caesarean section. ⋯ Giving 37.5 mg ephedrine i.m. prior to spinal anaesthesia was not associated with reactive hypertension or tachycardia. Intramuscular ephedrine provided more sustained cardiovascular support than intravenous ephedrine.
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The gradient between temperatures measured at different body sites is not constant; one factor which will change this gradient is rapid changes in body temperature. Measurement of this gradient was done in patients undergoing rapid changes in body temperature to establish the best site to measure temperature and to compare two brands of commercial tympanic thermometers. ⋯ Oesophageal temperature is more accurate and will reflect rapid changes in body temperature better than tympanic, axillary, or rectal temperature. When oesophageal temperature cannot be measured, tympanic temperature done by a trained operator should become the reading of choice.