Canadian journal of anaesthesia = Journal canadien d'anesthésie
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To review the pattern of malpractice litigation related to regional anesthesia in Canada. ⋯ Twenty percent of all anesthesia claims in Canada are related to regional anesthesia. The legal outcome of these claims is favourable in 90%. Unfavourable clinical outcome is associated with catastrophic or major injury. There were no deaths in the regional anesthesia claims.
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To describe negative pressure pulmonary edema due to biting of the laryngeal mask tube at emergence from general anesthesia. ⋯ Airway obstruction due to biting of a laryngeal mask tube may result in negative pressure pulmonary edema.
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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.