Canadian journal of anaesthesia = Journal canadien d'anesthésie
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The auditory evoked potential (AEP) has been proposed as a method to determine depth of anesthesia, as AEPs are generated in the thalamus and cerebral cortex. Because general anesthesia, in part, relies on anesthetic action in the spinal cord, we hypothesized that isoflurane would have indirect depressant effects on the AEP because of its action in the spinal cord. ⋯ Isoflurane action in the spinal cord indirectly alters the AEP, however, the effect is small. These data suggest that isoflurane can depress the transmission of afferent information from the spinal cord to thalamus, midbrain and cerebral cortex.
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To describe a novel technique of tracheal intubation and ventilation in an adult patient with a large tracheoesophageal fistula at the level of the carina. ⋯ Double endobronchial intubation is described to manage anesthesia in an adult patient with a tracheoesophageal fistula at the level of the carina.
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To report the detection of subarachnoid and intravascular catheter placement using nerve stimulation through an epidural catheter. ⋯ The new test provides objective information in managing epidural catheters when their position is uncertain.
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Treatment with angiotensin-converting enzyme (ACE) inhibitors affects the autoregulation of renal blood flow and glomerular filtration and provides renal protective effects. The purpose of this case-control study was to investigate the effects of chronic ACE inhibition on perioperative renal hemodynamics and function. ⋯ Long term treatment with ACE inhibitors does not influence the perioperative changes in renal hemodynamics and function. During cardiopulmonary bypass, a transient impairment in solute reabsorption is associated with renal release of vasodilatory mediators (nitric oxide and prostacyclin).
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To evaluate the experience of the operator and the time of epidural anesthesia as factors contributing to unintentional dural puncture (UDP). ⋯ Operator experience and hour of procedure appear to be two important risk factors of UDP The increased risk of UDP in night-work could result from human factors such as fatigue, sleep deprivation or interruption.