Canadian journal of anaesthesia = Journal canadien d'anesthésie
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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 compare surface and intramuscular laryngeal electromyography (EMG) with adductor pollicis muscle EMG after 0.1 mgxkg(-1) cisatracurium. ⋯ Surface laryngeal EMG is comparable to intramuscular laryngeal EMG to determine degree and onset of the neuromuscular blockade. Increasing muscle relaxation does not cause the surface electrode to lose contact with the vocal cords and therefore underestimate onset time and peak effect.
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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.
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To determine the effectiveness of lightwand-guided tracheal puncture for percutaneous tracheostomy. ⋯ The lightwand guided intratracheal puncture for percutaneous tracheostomy is a simple, effective, and safe procedure. This technique can avoid the risk of puncturing the endotracheal tube and/or cuff, thus allowing adequate ventilation and oxygenation during the percutaneous tracheostomy. Furthermore, this technique is inexpensive and minimizes the risk of damaging equipment like the fibreoptic bronchoscope.
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Randomized Controlled Trial Comparative Study Clinical Trial
The intubating LMA: a comparison of insertion techniques with conventional tracheal tubes.
To compare the performance of the intubating laryngeal mask airway (ILMA) in assisting blind tracheal intubation with conventional tracheal tubes of different curvatures and the frequency of possible associated complications. ⋯ Blind trachea intubation via an ILMA with the conventional curved tracheal tube is feasible and highly successful. Reverse curve direction is preferable at the first attempt of intubation for its higher success rate and lower incidence of complications.