Canadian journal of anaesthesia = Journal canadien d'anesthésie
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This is the first report describing combined spinal epidural anaesthesia for labour and unexpected Caesarean section in a patient with mitral and aortic stenosis and insufficiency. ⋯ Carefully planned regional anaesthesia was safely used for labour and operative delivery in this parturient with mitral and aortic valvular disease.
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Randomized Controlled Trial Clinical Trial
Propofol reduces succinylcholine induced increase of masseter muscle tone.
Succinylcholine is known to increase the tone of the masseter muscles. As excessive jaw tension may complicate rapid sequence induction, we investigated three induction techniques, all including the use of succinylcholine, with respect to masseter muscle tone, neuromuscular blockade, intubation conditions, and time course of intubation. ⋯ Jaw tension after administration of succinylcholine is influenced by the choice of induction agent. The increase of masseter muscle tone is lower following propofol or thiopentone/atracurium induction than with thiopentone alone.
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Advances in regional anaesthesia to date have made it one of the safest modalities for surgical anaesthesia and pain management. Continued refinement and development of new block techniques and approaches enhance the potential for block success, rapid postoperative recovery and patient safety. This will benefit both patient care and the health care economy.
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Clinical Trial Controlled Clinical Trial
Age related variability in the effects of mivacurium in paediatric surgical patients.
This study describes the effects of 0.3 mg.kg-1 mivacurium in 180 paediatric patients between the ages of one month and 13 yr. ⋯ The time course of block produced by mivacurium is more rapid in younger paediatric patients. The time course of mivacurium does not have the transatlantic variation which has been observed for vecuronium. Physiological changes suggestive of histamine release were frequent. Intubation conditions were very likely to be acceptable 90 sec after 0.3 mg.kg-1 mivacurium.
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Clinical Trial Controlled Clinical Trial
Combined nitric oxide inhalation, prone positioning and almitrine infusion improve oxygenation in severe ARDS.
To determine the efficacy and side effects of prone positioning (PP) and nitric oxide (NO) inhalation, alone, associated, or combined with i.v. almitrine for the treatment of hypoxaemia in severe acute respiratory distress syndrome (ARDS). ⋯ Prone Position improves PaO2/FiO2 significantly more than NO alone but less than PP + almitrine or NO + almitrine. The best results are obtained with the association of NO + Prone position + Almitrine.