Canadian journal of anaesthesia = Journal canadien d'anesthésie
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To determine if central sympathetic blockade by dexmedetomidine, a selective alpha(2) adrenergic receptor agonist, prevents cardiac dysfunction associated with intracranial hypertension (ICH) in a rat model. ⋯ The results demonstrate that dexmedetomidine attenuates cardiac dysfunction associated with ICH. Our results provide evidence for the role of central sympathetic hyperactivity in the development of cardiac dysfunction associated with ICH.
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Randomized Controlled Trial Clinical Trial
Aprotinin decreases the incidence of cognitive deficit following CABG and cardiopulmonary bypass: a pilot randomized controlled study.
Cognitive deficit after coronary artery bypass surgery (CABG) has a high prevalence and is persistent. Meta-analysis of clinical trials demonstrates a decreased incidence of stroke after CABG when aprotinin is administrated perioperatively. We hypothesized that aprotinin administration would decrease the incidence of cognitive deficit after CABG. ⋯ In this prospective pilot study, the incidence of cognitive deficit after CABG and cardiopulmonary bypass is decreased by the administration of high-dose aprotinin.
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We have evaluated randomized controlled trials of the administration of clonidine, neostigmine, steroids and non-steroidal anti-inflammatory agents intra-articularly as adjuvants to local anesthetic drugs after arthroscopic knee surgery. ⋯ Current evidence indicates that a variety of agents have synergistic effects when added to local anesthetics and there is evidence that the improvement in analgesia is, at least partially, through a local rather than a central mechanism. The results of this review suggest that clonidine and ketorolac, when administered intra-articulary after arthroscopic knee surgery, may reduce postoperative pain.
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Case Reports
Emergency gum elastic bougie-assisted tracheal intubation in four patients with upper airway distortion.
The gum elastic bougie (GEB) has been in use for a long time and allows tracheal intubation in most cases of difficult direct laryngoscopy. Use of the GEB when anatomical landmarks of the upper airway are not recognizable has not been reported. We describe our experience of airway management with the GEB in cases of severe upper airway distortion. ⋯ The GEB can be a valuable tool in cases of difficult airway management caused by upper airway distortion. The lack of visualization of normal pharyngeal structures did not prevent the successful insertion of the GEB in the trachea in the four patients reported.