Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial
The GlideScope-specific rigid stylet and standard malleable stylet are equally effective for GlideScope use.
The GlideScope videolaryngoscope usually provides excellent glottic visualization, but directing an endotracheal tube (ETT) through the vocal cords can be challenging. The goal of the study was to compare the dedicated GlideScope-specific rigid stylet to the standard malleable stylet, assessed by time to intubation (TTI). ⋯ In a group of experienced operators using the GlideScope, the dedicated GRS and the standard malleable ETT stylet are equally effective in facilitating endotracheal intubation.
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Randomized Controlled Trial
The addition of adrenaline to thoracic epidural meperidine does not improve analgesia following thoracotomy.
Patient-controlled epidural analgesia (PCEA) with meperidine provides effective analgesia following thoracotomy. Accumulation of normeperidine, a meperidine metabolite with neuroexcitatory effects, has led to recommendations to limit the use of meperidine postoperatively. The purpose of this study was to determine if the addition of adrenaline to PCEA meperidine decreased meperidine consumption, reduced serum normeperidine levels, and improved analgesia following thoracotomy. ⋯ The addition of adrenaline did not influence PCEA meperidine consumption, analgesia outcomes, or QoR. Normeperidine did not accumulate in patients of either study group during the 48-hr study period. Meperidine for patient controlled epidural analgesia, with or without adrenaline, provides effective post-thoracotomy analgesia in selected patients.
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Review Case Reports
Case report: ropivacaine neurotoxicity at clinical doses in interscalene brachial plexus block.
To describe a case of ropivacaine toxicity following an ultrasound guided interscalene block and discuss the possible mechanisms involved. ⋯ Local anesthetic toxicity is an uncommon but well documented complication of regional anesthesia. Careful monitoring and preparedness for managing complications during the conduct of regional anesthesia cannot be overemphasized. Experience from this case suggests that local anesthesia toxicity can happen within safe dose limits and without intravascular placement despite careful attention to needle and catheter placement, fractionated dosing and frequent aspirations.
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Randomized Controlled Trial
Dexamethasone reduces the severity of postoperative sore throat.
Dexamethasone may have potential advantages in the prevention of postoperative sore throat. We therefore undertook a study to evaluate the efficacy of intravenously administered dexamethasone in reducing the incidence and severity of postoperative sore throat in patients receiving general anesthesia with endotracheal intubation. ⋯ Preoperative administration of dexamethasone 8 mg iv reduces the incidence and severity of postoperative sore throat in patients receiving general anesthesia with endotracheal intubation.