Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Comparative Study
Bispectral index and regional cerebral oxygen saturation during propofol/N2O anesthesia.
A study was undertaken to compare the influence of midazolam, isoflurane, and aminophylline (which may antagonize anesthetic action) on bispectral index (BIS) and regional cerebral oxygen saturation (rSO(2)) during propofol/N(2)O anesthesia, and to test the hypothesis that the drug-induced changes in BIS values are accompanied by a change in rSO(2). ⋯ Midazolam or isoflurane-induced decreases in the BIS during propofol anesthesia were not accompanied by a decrease in rSO(2). Aminophylline significantly increased the BIS score during propofol anesthesia, suggesting that aminophylline can antagonize, at least in part, the sedative actions of propofol.
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We report an unusual case of vocal cord edema associated with the use of a ProSeal laryngeal mask airway (PLMA) in an adult patient with an undiagnosed upper respiratory tract infection (URTI). ⋯ Airway hyperreactivity secondary to the URTI is the most likely etiological factor; other possibilities include trauma from insertion and chemical irritation. Although pediatric studies suggest that the LMA-Classic carries less risk than endotracheal intubation in the presence of URTI, this case report demonstrates that caution is still warranted when using supraglottic airways. The PLMA permitted effective ventilation despite increased airway resistance; nevertheless its role in patients with URTI is unclear. It is possible that the bulkier cuff design of the PLMA, compared to that of the LMA-Classic, may have partly contributed to the development of edema in this setting.
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Randomized Controlled Trial Comparative Study
Remifentanil versus propofol for radio frequency treatment of atrial flutter.
Radio frequency treatment in cardiology generates short acute pain during the heating process. The present study evaluates two techniques used for sedation/analgesia for this procedure. ⋯ A basal infusion of remifentanil plus remifentanil patient controlled analgesia and target controlled infusion of propofol were adequate but not optimal techniques for sedation/analgesia for radio frequency treatment of atrial flutter.
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Randomized Controlled Trial Comparative Study
Suction catheter guided insertion of the ProSeal laryngeal mask airway is superior to the digital technique.
We tested the hypothesis that digital insertion of the ProSeal laryngeal mask airway (ProSeal LMA) is more successful when using a suction catheter (SC) as a guide. ⋯ The SC-guided technique is more frequently successful than the digital technique and is associated with less mouth trauma during insertion of the ProSeal LMA. We suggest that the SC technique may be a useful alternative when the digital technique fails.