Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Review Meta Analysis Comparative Study
Patient-controlled versus nurse-controlled analgesia after cardiac surgery--a meta-analysis.
Patient-controlled analgesia (PCA) has been advocated as superior to conventional nurse-controlled analgesia (NCA) with less risk to patients. This systematic review and meta-analysis sought to determine whether PCA improves clinical and resource outcomes when compared with NCA. ⋯ In postcardiac surgical patients, PCA increases cumulative 24 and 48 hr morphine consumption, and improves 48-hr VAS compared with NCA.
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Randomized Controlled Trial Comparative Study
Doxapram shortens recovery following sevoflurane anesthesia.
A randomized, double blind controlled trial was undertaken to investigate the effect of doxapram on recovery times and bispectral index following sevoflurane anesthesia. ⋯ We conclude that doxapram 1 mg.kg(-1) hastens early recovery from sevoflurane anesthesia, and this arousal effect correlates with higher bispectral index values.
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Randomized Controlled Trial Comparative Study
Laryngoscopic evaluation with the Airway Cam.
The Airway Cam is a head-mounted direct laryngoscopy video system which uses a prismatic sighting system that aligns with the operator's line of sight. This study evaluated intra- and inter-observer consistency in laryngoscopy grading comparing direct laryngoscopy to the laryngoscopy grade obtained with the Airway Cam. ⋯ This study validates that the view recorded by the Airway Cam reflects the view of the laryngoscopist. The Airway Cam may introduce an additional level of objectivity into airway management research and teaching.
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Proteinuria is a non-specific marker of inflammation that may reflect the glomerular component of systemic capillary leak. The objective of this pilot study was to determine if postoperative proteinuria is associated with adverse outcomes following cardiac surgery with cardiopulmonary bypass. ⋯ Proteinuria two to four hours after cardiac surgery with cardiopulmonary bypass may be a useful marker for systemic capillary leak and adverse postoperative events. Large prospective studies are needed to confirm these findings.
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Case Reports
Extubation of the surgically resected airway--a role for remifentanil and propofol infusions.
To report the use of propofol and remifentanil infusions to facilitate smooth extubation of a surgically resected airway. ⋯ Propofol and remifentanil infusions in combination can facilitate successful extubation of the surgically resected airway with high risk of disruption.