Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Clinical Trial
Propofol or sevoflurane anesthesia without muscle relaxants allow the early extubation of myasthenic patients.
To compare two non-muscle relaxant anesthetic techniques in myasthenic patients undergoing trans-sternal thymectomy, evaluating the intra- and postoperative conditions including the early extubation in the operating room. ⋯ Our data show that these two anesthetic techniques allow the early extubation of myasthenic patients in the operating room.
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Case Reports
Reduced duration of muscle relaxation with rocuronium in a normocalcemic hyperparathyroid patient.
To report a case of reduced duration of action of rocuronium in a patient with normocalcemic hyperparathyroidism (HPT). ⋯ Primary HPT even in the absence of hypercalcemia may result in resistance to competitive blockade by rocuronium. It suggests that primary HPT may cause acetylcholine receptor up-regulation resulting in hyposensitivity to non-depolarizing muscle relaxants.
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Letter Randomized Controlled Trial Clinical Trial
Continuous epidural infusion of ropivacaine with sufentanil 1.5 microg x mL(-1) for postoperative analgesia after total knee replacement.
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Case Reports
Anesthetic management of a ventilator-dependent parturient with the King-Denborough syndrome.
The King-Denborough syndrome (KDS) is a rare disorder that is associated with myopathy, susceptibility to malignant hyperthermia (MH) as well as congenital skeletal and facial anomalies. We report the anesthetic management of a parturient with KDS. ⋯ The use of epidural analgesia, close monitoring and collaboration between the various disciplines were important in achieving a safe and uneventful labour in this high-risk parturient.
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To report a case where failure to provide adequate one-lung ventilation during transbronchial intubation resulted in a potentially fatal mishap. ⋯ Displacement of the double-lumen endobronchial tube and flooding with clotted blood will result in potentially fatal ventilation difficulties. Repositioning and cleaning of the tube must be prompt to reduce the risk of hypoxemia. Where emergency single-lung ventilation is required, we suggest the utilization of a modified single-lumen endotracheal tube with a shortened cuff-tip length to ensure an adequate margin of safety for mainstem bronchus intubation.