Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Case Reports
Combined spinal-epidural anesthesia for Cesarean section in a patient with peripartum dilated cardiomyopathy.
To report a case of peripartum dilated cardiomyopathy associated with morbid obesity and possible difficult airway presenting for elective Cesarean section, which was successfully managed with combined spinal-epidural anesthesia. ⋯ In patients suffering from peripartum cardiomyopathy, undergoing Cesarean section, combined spinal-epidural anesthesia may be an acceptable anesthetic alternative.
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Case Reports
Confirmation of internal jugular guide wire position utilizing transesophageal echocardiography.
To describe the utility of transesophageal echocardiography (TEE) in confirmation of correct central line J-wire position. ⋯ The case demonstrates the value of TEE to confirm correct guide wire position prior to insertion of a large bore central venous catheter. TEE visualization of J-wire position avoided repeat attempts at internal jugular cannulation and potential carotid artery puncture.
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To assess overall job satisfaction among Canadian anesthesiologists and examine contributing factors. ⋯ Job satisfaction among anesthesiologists is significantly associated with intellectual stimulation, quality of care, interaction with the patients, treatment from the provincial government, hospital politics, working hours, OR assistance and perceived attitude of surgeons. Improving these contributing factors may lead to higher job satisfaction.
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Randomized Controlled Trial Clinical Trial
Low dose intrathecal ropivacaine with or without sufentanil provides effective analgesia and does not impair motor strength during labour: a pilot study.
Although ropivacaine has been used to provide spinal anesthesia in the surgical population, its intrathecal administration for labour analgesia has only recently been described. We evaluated the effects of low dose intrathecal ropivacaine with or without sufentanil for labour analgesia. ⋯ Low dose ropivacaine provides effective analgesia during labour via the intrathecal route. It can be mixed with sufentanil in the above-mentioned concentrations to improve both the quality and duration of analgesia. Fetal outcome remains favourable. It may provide minimal or no motor block, to facilitate ambulation.
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Randomized Controlled Trial Clinical Trial
Sevoflurane with remifentanil allows rapid tracheal intubation without neuromuscular blocking agents.
After inhalational induction with sevoflurane, we compared the effects of adding remifentanil 1 microg x kg(-1) or remifentanil 2 microg x kg(-1) on conditions for tracheal intubation without neuromuscular blocking agents. ⋯ The addition of remifentanil after sevoflurane induction allows for rapid tracheal intubation without neuromuscular blocking agents. The higher dose of remifentanil results in improved conditions for tracheal intubation but also caused a greater decrease in mean arterial pressure. Tracheal intubation using sevoflurane and remifentanil may be an alternative to traditional tracheal intubation with neuromuscular blocking agents.