Canadian journal of anaesthesia = Journal canadien d'anesthésie
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To provide evidence-based guidelines for the prophylaxis and treatment of postoperative nausea and vomiting (PONV). ⋯ PONV are common after anesthesia and surgery. We provided evidence-based guidelines for the management of this problem based on the available literature.
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Randomized Controlled Trial Clinical Trial
Low alfentanil target-concentrations improve hemodynamic and intubating conditions during induction with sevoflurane.
To investigate the effects of different alfentanil target-concentrations on hemodynamics, respiration and conditions of tracheal intubation during an inhalation induction with 8% sevoflurane. ⋯ Adding alfentanil at a 75 ng*mL(-1) target-concentration during an inhalation induction with 8% sevoflurane in 50% nitrous oxide allows intubation slightly earlier and provides stable hemodynamic conditions but the incidence of apnea during induction is higher. Lower concentrations are of little clinical interest.
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Randomized Controlled Trial Comparative Study Clinical Trial
Desflurane accelerates patient response during the wake-up test for scoliosis surgery.
To evaluate if desflurane possesses a shorter wake-up onset time and less incidence of recall than fentanyl-based anesthesia. ⋯ DES provides a significantly shorter onset time during the wake-up test and a rapid emergence after scoliosis surgery. BIS monitoring during the wake-up test was more informative when anesthesia was maintained with DES compared to FEN infusion.
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Evaluate the efficacy of advanced life support interventions using the pediatric Utstein guidelines. ⋯ For intravenously administered epinephrine, a dose of 0.01 mg*kg(-1) seems appropriate as the first dose. The endotracheal route is a valuable alternative for epinephrine administration and, for infants, the dose does not need to be increased. A minimal resuscitation duration time of 30 min can be misleading if ROSC is used as the indicator.
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In a previous survey, patients at risk for postoperative nausea and vomiting (PONV) were best identified by a simplified risk score. Consequently, we investigated whether a risk score-dependent antiemetic strategy could effectively reduce the incidence of PONV in our department. ⋯ This is the first survey which suggests that the departmental incidence of PONV can be significantly lowered by a risk score-dependent antiemetic strategy through a quality improvement initiative.