Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Although it has been suggested that the rate at which the cerebral circulation responds to changes in PaCO2 is different with differing anesthetics, there have been no attempts to measure this. Transcranial Doppler allows the continuous measurement of cerebral blood flow velocity (CBFV) and any changes over time. Our aim was to compare the rate of change of CBFV when end-tidal CO2 (P(ET)CO2) was rapidly altered during halothane or isoflurane anesthesia. ⋯ The rate of change of CBFV was faster in the isoflurane than in the halothane group especially in the initial few minutes. Indeed, for two patients in the halothane group Vmca did not change despite a change in P(ET)CO2. This may be of clinical importance when cerebrovascular tone needs to be changed rapidly.
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To clarify the recent perception of shortfalls in anesthesia physician resources, two models were used to assess these resources in Ontario, Canada. ⋯ This conservative approach indicates that the shortfall in anesthesiologist physician resources will worsen by 2005.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of patient-controlled analgesia fentanyl and alfentanil for labour analgesia.
To determine the analgesic efficacy of equipotent doses of PCA (patient-controlled analgesia) fentanyl and PCA alfentanil for labour pain. ⋯ In the doses prescribed in this study, PCA fentanyl was found to provide more effective analgesia in late first stage labour than PCA alfentanil.
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Normothermic cardiopulmonary bypass (CPB) has been recently used in cardiac surgery. However, there is a controversy whether there is a difference in incidence of neurological disorder after coronary artery bypass graft (CABG) surgery between normothermic CPB and mild hypothermic CPB. In this study, we assessed the effects of normothermia and mild hypothermia (32 degrees C) during CPB on jugular oxygen saturation (SjvO2). ⋯ Cerebral oxygenation, as assessed by SjvO2 was increased during mild hypothermic CPB than during normothermic CPB.
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Comparative Study
Neuromuscular effects of rapacuronium in pediatric patients during nitrous oxide-halothane anesthesia: comparison with mivacurium.
To describe neuromuscular effects of rapacuronium in pediatric patients during N2O-halothane anesthesia and compare them with mivacurium in children. ⋯ Rapacuronium produces block earlier than mivacurium. Recovery from rapacuronium block is dose related and slower than that following mivacurium during halothane anesthesia.