Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Clinical Trial
Tramadol 2.5 mg x kg(-1) appears to be the optimal intraoperative loading dose before patient-controlled analgesia.
We previously established that a 5 mg x kg(-1) intraoperative dose can reduce the nausea/vomiting associated with tramadol patient-controlled analgesia (PCA). This study was conducted to identify the most appropriate initial dose to improve the quality of tramadol PCA. ⋯ When considering efficacy and side-effect profile, 2.5 mg x kg(-1) of tramadol is the optimal intraoperative dose of this drug to provide effective postoperative analgesia with minimal sedation.
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To establish the appropriate inhalation induction technique using a high concentration of sevoflurane in the elderly. ⋯ Our results suggest that a high concentration sevoflurane induction using a gradual reduction technique may be an acceptable alternative to standard iv induction in elderly patients.
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Randomized Controlled Trial Comparative Study Clinical Trial
LMA-Classic and LMA-ProSeal are effective alternatives to endotracheal intubation for gynecologic laparoscopy.
To compare the laryngeal mask airways (LMA), LMA-Classic(TM) (LMA-C) and LMA-ProSeal(TM) (PLMA) with the endotracheal tube (ETT) with respect to pulmonary ventilation and gastric distension during gynecologic laparoscopy. ⋯ A correctly placed LMA-C or PLMA is as effective as an ETT for positive pressure ventilation without clinically important gastric distension in non-obese and obese patients.
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Continuous interscalene brachial plexus blockade (CIBPB) in a hospital setting can provide excellent surgical conditions and postoperative analgesia for major shoulder surgery. This is a case report of four patients on the efficacy and advantages of CIBPB for postoperative analgesia at home. ⋯ The use of CIBPB for 72 hr in patients undergoing major ambulatory shoulder surgery can result in good analgesia with minimal opioid requirement, cost savings and possibly improvement in outcome measures.
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Sciatic nerve block is useful for surgery below the knee both intra- and postoperatively. Several techniques to insert a catheter at the knee level or higher have been described but need mobilization (lateral decubitus) of the patient. We describe novel landmarks, using a high lateral approach, to block the sciatic nerve without moving the patient. ⋯ The lateral technique for sciatic nerve anesthesia and catheter insertion allows patients to remain in the supine position for performance of the block and catheter insertion, and results in a high rate of homogeneous anesthesia and a low incidence of side effects.