Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Clinical Trial
Propofol decreases cerebral blood flow velocity in anesthetized children.
Propofol, by virtue of its favourable pharmacokinetic profile, is suitable for maintenance of anesthesia by continuous infusion during neurosurgical procedures in adults. It is gaining popularity for use in pediatric patients. To determine the effects of propofol on cerebral blood flow in children, middle cerebral artery blood flow velocity (Vmca) was measured at different levels of propofol administration by transcranial Doppler (TCD) sonography. ⋯ This study shows that a higher rate of propofol infusion is associated with lower CBFV and MAP values in children. Propofol's cerebral vasoconstrictive properties may be responsible for this finding.
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To report a case of pulmonary soiling of the dependent and of the non-dependent remaining lung when a Univent tube was used to achieve one-lung ventilation (OLV). ⋯ Whenever a bronchial blocker is used for OLV, we should be cautious about the possibility that secretions accumulated distal to the blocker may contaminate the dependent or the non-dependent remaining lung.
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To verify if correct ProSeal laryngeal mask airway (PLMA) placement may condition blind insertion of a gastric tube via the PLMA. ⋯ Partial or total visualization of the vocal cords makes the success of gastric tube insertion more probable. Considering that fibreoptic visualization of the glottic aperture is associated with ease of insertion of a gastric tube (P < 0.02), the authors recommend adjusting or reinserting the PLMA if difficulty during the initial positioning of the gastric tube is experienced.
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To present a case of postpartum bilateral intracranial subdural hematoma after dural puncture during attempted epidural analgesia for labour. ⋯ It is conceivable that thrombocytopenia together with possible abnormal platelet function increased the risk of subdural hematoma. Alternative diagnoses to PDPH should be considered whenever headache is not posturally related.
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This study assessed difficult airway management, training and equipment availability among Canadian anesthesiologists. ⋯ Our survey assessed current preferences, training and equipment availability for the difficult airway amongst Canadian anesthesiologists. Direct laryngoscopy and fibreoptic bronchoscopy were the preferred technique for intubation despite widespread availability of newer airway equipment. Lack of certain essential airway equipment and difficult airway training should be addressed.