Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Clinical Trial
Midazolam premedication reduces propofol requirements for sedation during regional anesthesia.
Propofol is often used for sedation during spinal anesthesia. We investigated the effects of midazolam premedication on the propofol requirements and incidence of complications during sedation. ⋯ Midazolam premedication reduced propofol requirements and the incidence of intraoperative memory during sedation. These effects on sedation using propofol during spinal anesthesia are considered beneficial for patients.
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Randomized Controlled Trial Clinical Trial
Epidural naloxone reduces pruritus and nausea without affecting analgesia by epidural morphine in bupivacaine.
To determine whether epidural naloxone preserved analgesia while minimizing side effects caused by epidural morphine. ⋯ Epidural naloxone reduced morphine-induced side effects in dose-dependent fashion without reversal of the analgesic effect.
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Perioperative coronary artery occlusion is a potentially dangerous complication causing myocardial infarction and circulatory collapse. We report a case showing severe ST segment depression in leads II and V5 during anesthesia. Diltiazem and nifedipine, but not nitroglycerine, partially improved the ST changes which were normalized by a percutaneous cardiopulmonary system (PCPS). ⋯ Calcium channel blockers were more effective than nitroglycerine in treating perioperative ST depression. However, none of them produced complete reversal of the ischemic changes which were normalized with PCPS.
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To describe a patient with probable choledochal sphincter spasm after preoperative morphine, and to suggest a history of cholecystectomy as a predisposing factor. ⋯ Choledochal sphincter spasm should be part of a differential diagnosis in right upper quadrant pain after sedative doses of morphine, especially if there is a previous cholecystectomy.