Canadian journal of anaesthesia = Journal canadien d'anesthésie
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The current bedside "gold standard" for cardiac output (CO) monitoring is thermodilution using a pulmonary artery catheter (PAC) but there is a number of risks associated with its use. The primary objective of this review was to evaluate the utility of esophageal Doppler (ED) as a minimally invasive monitor of CO. ⋯ ED is a practical, reliable, and valid device for measuring CO in perioperative and critically ill patients. Further studies with larger numbers of patients are needed to determine if the limited precision observed is inherent to the technique, the diagnoses of patients studied, or the small sample sizes.
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To describe a case of intraoperative passive regurgitation where the ProSeal laryngeal mask airway (PLMA) successfully protected the airway from the respiratory tract. ⋯ This case illustrates that passive regurgitation can occur unexpectedly intraoperatively and shows that the PLMA can protect the airway during such an event by allowing the regurgitated fluid to pass up the drainage tube without leaking into the glottis.
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To examine the inotropic and chronotropic effects of xenon (Xe) and nitrous oxide (N2O) compared with nitrogen (N2) on isolated rat hearts. The differences between Xe and N2O were also compared. ⋯ Our data suggest that cardiac contractility was decreased by the effects of reduced O2 delivery, but both Xe and N2O did not cause further cardiac depressant effects compared to N2 in this experimental model.
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Randomized Controlled Trial Comparative Study Clinical Trial
Intra-synovial, compared to intra-articular morphine provides better pain relief following knee arthroscopy menisectomy.
To evaluate the analgesic effect of morphine 1 mg administered into the synovial tissue and the outer third of the meniscus after knee arthroscopy. ⋯ We conclude that direct morphine injection into the synovia or the outer third of the meniscus provided better pain relief than intra-articular morphine after knee arthroscopy.
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Randomized Controlled Trial Comparative Study Clinical Trial
Desflurane improves the throughput of patients in the PACU. A cost-effectiveness comparison with isoflurane.
In a pharmacoeconomic approach of anesthesia, postanesthesia care unit (PACU) occupancy can be chosen as a criteria of effectiveness to compare two anesthetic drugs with different rates of elimination and different costs of administration. Our objective was to develop a cost-effectiveness approach for the comparison of isoflurane (I) and desflurane (D). ⋯ Improving the throughput of patients in PACU by using new halogenated anesthetic agents with faster rates of elimination may outweigh the incremental cost of this strategy. This becomes particularly meaningful in operating theatres experiencing frequent overcrowded periods.