Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Historical Article
Training and development of anesthesia in Nepal - 1985 to 2005.
To describe the self-sustaining anesthesia training and development program in Nepal from 1985 through 2005, and the Canadian contributions. ⋯ The devotion of Nepalese anesthesiologists in teaching and training, strong guidance from Canadian medical faculties, and local government support have contributed to the successful development of Nepalese anesthesia training programs. Establishment of the training programs has assisted recruitment of trained anesthesiologists to different regional hospitals. Finally, the formation of a national society, with an organized annual symposium has improved professional self-esteem, and raised the profile of anesthesiology in Nepal.
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Case Reports
Aortic dissection and hypothermic arrest in a Jehovah's Witness patient: a case for recombinant factor VIIa?
To present a case of survival of a cognitively intact Jehovah's Witness patient with an aortic dissection who underwent hypothermic arrest. Recombinant factor VIIa, but no blood products were administered. ⋯ Patients who conscientiously object to the transfusion of blood products may present a considerable anesthetic challenge, especially those at risk from coagulopathy associated with CPB and hypothermic circulatory arrest. Recombinant factor VIIa may play a role in hemostasis management of these individuals, however, well-designed randomized controlled trials need to be undertaken to establish the efficacy and risks related to this potential indication.
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It has been speculated that the severity of obstructive sleep apnea syndrome (OSAS) is related to difficult intubation. However, this has not been confirmed in OSAS patients. Thus, we undertook a retrospective study to assess this relationship in patients who had undergone uvulopalatopharyngoplasty (UPPP) surgery for OSAS. ⋯ This study shows that the occurrence of difficult intubation can be predicted using AHI in patients who undergo UPPP surgery for OSAS.
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Case Reports
Targeted thoracic epidural blood patch placed under electrical stimulation guidance (Tsui test).
This case report describes the use of electrical epidural stimulation (Tsui test) to confirm accurate placement of a thoracic epidural catheter when administering an epidural blood patch for headache management in a patient suffering from spontaneous intracranial hypotension. ⋯ The use of electrical stimulation guidance may be useful when precise epidural blood patch placement is required.