Canadian journal of anaesthesia = Journal canadien d'anesthésie
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To report an unusual case of pulmonary edema following intramuscular ketamine administration. ⋯ Ketamine was given im to aid burns dressing in this case because it has distinct advantages above the other anesthetic agents including that of being a good analgesic which is absorbed by im route. Its use led to the development of pulmonary edema.
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Randomized Controlled Trial Clinical Trial
Midazolam attenuates ketamine-induced abnormal perception and thought process but not mood changes.
To determine the effects of midazolam, 30 ngxmL(-1), on altered perception, mood, and cognition induced by ketamine. ⋯ Midazolam attenuates ketamine-induced changes in perception and thought process.
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Case Reports Clinical Trial
Elastomeric pumps for ambulatory patient controlled regional analgesia.
To report our experience with the use of the (Eclipse) elastomeric pump for ambulatory Patient Controlled Regional Analgesia (PCRA) METHOD: After a pilot study using this device in patients admitted to the hospital, seven patients received PCRA at home using the elastomeric pump. Patients with a variety of continuous regional anesthetic blocks were sent home with written and verbal instructions regarding the use of this device, boluses, side effects of local anesthetics and removal of block catheters. Patients were contacted daily to collect data with regards to the efficacy of the block, problems associated with the use of this device and their satisfaction with the method of analgesia. ⋯ PCRA offers excellent postoperative analgesia at home. Elastomeric pumps facilitate PCRA but are imprecise with drug delivery and may not be safe for epidural infusions. The safety of this device for peripheral nerve blocks should be evaluated further.
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To report a case of anaphylaxis to rocuronium and the sensitivities to multiple neuromuscular blocking drugs in a patient with no previous exposure to this group of drugs. We describe the current recommendations for both intraoperative and postoperative testing of these patients. ⋯ Muscle relaxants are responsible for 61.6% of cases of anaphylaxis during general anesthesia. Cross-reactivity is common, as this group of drugs share a quaternary ammonium group. It is mandatory that patients be tested for both the agent responsible and cross-reactivity following an anaphylactic response. We suggest a protocol for investigation of suspected anaphylaxis.
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To report the use of continuous brachial plexus analgesia to facilitate physiotherapy ⋯ This technique was successful with no major complications and resulted in a marked reduction in pain, with improved range of finger movement and general upper limb function.