Canadian journal of anaesthesia = Journal canadien d'anesthésie
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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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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.
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Randomized Controlled Trial
N-acetylcysteine for preventing acute kidney injury in cardiac surgery patients with pre-existing moderate renal insufficiency.
N-acetylcysteine may prevent acute kidney injury after cardiac surgery. To determine if N-acetylcysteine warrants definitive evaluation in a large multicentre trial, we evaluated its effects on a surrogate outcome, estimated glomerular filtration rate (eGFR), in a randomized trial. ⋯ N-acetylcysteine did not cause a statistically significant improvement in postoperative eGFR in this single-centre study. Nonetheless, its treatment effect was consistent with a plausible small-to-moderate benefit. Given this finding, N-acetylcysteine should be definitively evaluated in a large randomized trial.
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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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In 2006 a program leading to a Master's degree in Anesthesia (MMed) was established in Rwanda as a joint venture between the National University of Rwanda (NUR), the Canadian Anesthesiologists' Society International Education Fund (CASIEF) and the American Society of Anesthesiologists Overseas Teaching Programme (ASAOTP). A MMed in Anesthesia is similar to a Fellowship in Canada and is common in many African countries. Most training programs are of three years duration. Rwanda has decided on a four-year program. ⋯ In time, it is hoped that Rwanda will become self-sufficient in training its own anesthesiologists and in retaining them to provide anesthesia services throughout the country. As anesthesia and surgery evolve, there will be a need for subspecialty training in anesthesia. It is hoped that, with continued assistance from the CASIEF and ASAOTP, the goal of the NUR will be achieved.