Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Perioperative beta-blockade appears to reduce morbidity and mortality in non-cardiac surgery, and is recommended by published guidelines. This study explores the frequency of perioperative beta-blockade and identifies factors limiting its use. ⋯ Use of preoperative beta-blockade among suitable candidates appears to be approximately 40%. Anesthesiologists started preoperative beta-blockers infrequently even in patients without contraindications. These findings suggest that educating anesthesiologists about the perioperative use of beta-blockade may increase the use of this potentially beneficial strategy.
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Case Reports
Laryngo-tracheo-bronchial stenosis in a patient with primary pulmonary amyloidosis: a case report and brief review.
To report a case of lower respiratory tract obstruction occurring in a patient with primary pulmonary amyloidosis and discuss anesthetic management. ⋯ Primary laryngo-tracheo-bronchial amyloidosis is a recurrent disease, requiring repetitive surgical procedures. Airway compromise can be a persistent problem. Awareness of this uncommon disease process and its presentation may serve to caution the anesthesiologist presented with this type of case.
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Sciatic nerve blocks through lateral approaches in the popliteal fossa have been proposed. We describe a new medial approach to the sciatic nerve at this level. ⋯ We describe a new medial approach to the sciatic nerve in the popliteal fossa. More studies will be required to demonstrate the technique is effective and safe.
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Bilateral sixth nerve palsy is a known though uncommon complication following dural puncture. The recommended treatment consists of hydration and alternate monocular occlusion. The value and the timing of an epidural blood patch (EBP) for sixth nerve palsy remains controversial as some authors have demonstrated benefits in performing an EBP early in course of the nerve palsy whereas others have not found any advantage when an EBP was performed later. ⋯ Blood patching within 24 hr of the onset of diplopia may be a reasonable treatment for ocular nerve palsy as it relieved the postdural puncture headache and produced partial improvement of the diplopia.
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Editorial Comment
Anesthesia-related medication error: time to take action.