Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Meta Analysis
Examining the evidence in anesthesia literature: a survey and evaluation of obstetrical postdural puncture headache reports.
To describe a bibliographic database on the literature of postdural puncture headache (PDPH) in the obstetrical population, to describe the research architecture in this field, and to evaluate the quality of case-control studies, cohort studies, and controlled clinical trials on PDPH. ⋯ Although the amount of research on PDPH in parturients is increasing, use of optimal study designs and improvement in methodology is needed.
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Randomized Controlled Trial Clinical Trial
Continuous epidural infusion of racemic methadone results in effective postoperative analgesia and low plasma concentrations.
To compare two protocols of epidural administration of racemic methadone for postoperative analgesia (continuous infusion and intermittent bolus), focussing on plasma concentration, analgesic efficacy and side effects. ⋯ Plasma methadone concentrations were significantly lower with continuous infusion. Plasma methadone accumulation, which is considered the main disadvantage for its purported influence on the incidence of side effects, did not occur at the doses used over the three days of treatment that we report.
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Difficult intubation is a major problem in anesthesia. In case of limited mouth opening only a few intubating devices are available. Our study was designed to evaluate the effectiveness and safety of a modified transillumination technique for nasotracheal intubation (NTI). ⋯ Modification of the technique facilitated transillumination and placement of the ETT. The simplicity and high success rate of NTI by transillumination with the TL suggest our modified technique is a valuable alternative for NTI in patients with difficult airway.
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To review the efficacy and reliability of oxygen concentrators used over the last six years in Nepal. The apparatus used was a DeVilbiss(R) oxygen concentrator that provided O(2) for anesthesia supplemented with compressed air to drive a Penlon Manley Multivent Ventilator(R). It remains difficult to supply oxygen in cylinders to peripheral hospitals in Nepal due to lack of proper roads. ⋯ With regular maintenance and servicing done locally, the oxygen concentrator can be used safely in adults and children. Use of the oxygen concentrator is a suitable alternative to oxygen cylinders in the developing world.
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Randomized Controlled Trial Comparative Study Clinical Trial
Lidocaine with fentanyl, compared to morphine, marginally improves postoperative epidural analgesia in children.
To compare the epidural administration of fentanyl (1 microg/mL) combined with lidocaine 0.4% to preservative-free morphine for postoperative analgesia and side effects in children undergoing major orthopedic surgery. ⋯ Postoperative epidural fentanyl with lidocaine infusion provides slightly better analgesia than conventional bolus administration of epidural morphine. Side-effects or risk of systemic toxicity were not augmented by the addition of lidocaine to epidural opioids.