Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial
A heated humidifier does not reduce laryngo- pharyngeal complaints after brief laryngeal mask anesthesia.
Warming and humidification of inspired gases is standard care for intubated patients whose lungs are ventilated mechanically for prolonged periods. We examined whether active humidification of inspired gases might reduce laryngo-pharyngeal discomfort in patients undergoing brief laryngeal mask airway (LMA) anesthesia. ⋯ Active warming and humidification of inspired gases has no clinically appreciable effect in reducing the incidence and severity of laryngo-pharyngeal complaints after brief (
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Review Case Reports
Case report: epidural blood patch in the treatment of abducens palsy after a dural puncture.
To describe a case of iatrogenically induced abducens nerve palsy following a diagnostic lumbar puncture, and to review the evidence for blood patching in the management of sixth cranial nerve palsy after dural puncture. ⋯ Experience from this case as well as other case report evidence suggest that an epidural blood patch performed more than 24 hr after the onset of a sixth cranial nerve palsy consistently fails to relieve diplopia. An epidural blood patch executed within 24 hr from the onset of diplopia could possibly lead to partial improvement and/or earlier resolution of symptoms.
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The Esophageal-Tracheal Combitube (Combitube) is widely used for the management of the airway during cardiopulmonary resuscitation in the pre-hospital setting. Although serious complications have been reported with the Combitube, there is a paucity of data relative to the frequency and nature of such complications. The objective of this retrospective study was to determine the incidence and the nature of complications associated to the Combitube in the pre-hospital setting. ⋯ The use of the Combitube in the pre-hospital setting is associated with a notable incidence of serious complications.
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Cardiac surgery with cardiopulmonary bypass requires systemic anticoagulation, defined by an activated clotting time (ACT) of 400-480 sec. Patients with altered heparin responsiveness require disproportionately higher doses of heparin to achieve this target ACT. A common risk factor for heparin resistance is preoperative heparin therapy. Recently, therapy with low molecular weight heparin (LMWH) has become an acceptable substitute for prolonged heparin therapy. The current study examines the effect of preoperative LMWH therapy on subsequent heparin responsiveness during cardiac surgery. ⋯ Prolonged preoperative LMWH therapy, similar to the known effect of prolonged unfractionated heparin infusion, reduces subsequent intraoperative response to heparin.
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This study investigates the efficacy of preoxygenation with Mapleson A and Mapleson D breathing systems vs the circle system with CO2 absorber. ⋯ When using the Mapleson A and the circle systems for preoxygenation, an oxygen flow rate of 5 L.min-1 can adequately preoxygenate the patient within three minutes, while an oxygen flow of 10 L.min-1 is required to achieve a similar fractional end-tidal O2 concentration with the Mapleson D system.