Canadian journal of anaesthesia = Journal canadien d'anesthésie
-
Randomized Controlled Trial Comparative Study
Brief report: a randomized controlled trial of Synera versus lidocaine for epidural needle insertion in labouring parturients.
Skin infiltration with lidocaine, although brief, can be very stressful, painful, and may perpetuate anxiety. Synerat, a local anesthetic patch, which contains an oxygen-activated heating component to enhance the delivery of a eutectic mixture of lidocaine (70 mg) and tetracaine (70 mg), has provided analgesia for minor, dermatological procedures. We hypothesized that the analgesic effect of Synera, for pain in labouring parturients, would be superior to the traditional infiltration of lidocaine prior to epidural needle insertion. ⋯ The Synera patch provided inferior analgesia, for performing epidural labour analgesia in labouring parturients, compared to traditional infiltration with 2% lidocaine.
-
Norepinephrine (NE) infusions are commonly used in the intensive care unit and in the operating room. Data on long term stability of NE solutions are lacking. This prospective study was designed to evaluate the stability of NE, in dextrose (5%) in water (D5W) and in normal saline (NS) solutions, for a period up to seven days. ⋯ Norepinephrine solutions, in concentrations commonly used in the clinical setting, are chemically stable for seven days, at room temperature and under ambient light, when diluted either in D5W or NS.
-
Letter Case Reports
[Tracheal rupture after intubation with a right double lumen tube].
-
Review Meta Analysis
Is operative delay associated with increased mortality of hip fracture patients? Systematic review, meta-analysis, and meta-regression.
Mortality associated with hip fracture is high in elderly patients. Surgical repair within 24 hr after admission is recommended by The Royal College of Physicians' guidelines; however, the effect of operative delay on mortality remains controversial. The objective of this study was to determine whether operative delay increases mortality in elderly patients with hip fracture. ⋯ In hip fracture patients, operative delay beyond 48 hr after admission may increase the odds of 30-day all-cause mortality by 41% and of one-year all-cause mortality by 32%. Potential residual confounding factors in observational studies may limit definitive conclusions. Although routine surgery within 48 hr after admission is hard to achieve in most facilities, anesthesiologists must be aware that an undue delay may be harmful to hip fracture patients, especially those at relatively low risk or those who are young.