Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Comparative Study
Excellent intubating conditions with remifentanil-propofol and either low-dose rocuronium or succinylcholine.
The shortest time to tracheal intubation, the best intubating conditions, and the shortest duration of muscle paralysis are achieved with succinylcholine. During a lidocaine-remifentanil-propofol induction of anesthesia, we compared intubating conditions 90 s after administering low-dose rocuronium (0.3 mg . kg(-1)) with intubating conditions 60 s after administering succinylcholine 1.5 mg . kg(-1). ⋯ During a lidocaine-remifentanil-propofol induction of anesthesia, rocuronium 0.3 mg . kg(-1) administered before the induction sequence provides intubating conditions comparable to those achieved with succinylcholine 1.5 mg . kg(-1) administered after the induction sequence.
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A potential role for inducible nitric oxide synthase in the cerebral response to acute hemodilution.
Acute anemia increases the cerebral expression of hypoxic molecules including neuronal nitric oxide synthase (nNOS) and hypoxia inducible factor-1alpha (HIF-1alpha). This study assessed the effects of acute hemodilution on inducible NOS (iNOS) and systemic inflammatory cytokines. ⋯ Cerebral cortical iNOS and nNOS protein levels were both increased in anemic rats. The nNOS response was predominant. This suggests that NOS-derived NO may be an important signalling pathway which is activated in the brain during anemia. These cellular responses could maintain cerebral homeostasis, or contribute to neuronal injury, during acute hemodilutional anemia.
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In order to establish guidelines for the preparation of the Dräger Fabius GS premium anesthetic workstation for malignant hyperthermia-susceptible patients, the authors evaluated the effect of the workstation's exchangeable and autoclavable components on the washout of isoflurane. ⋯ Anesthetic washout from the Dräger Fabius GS is relatively slow. Although washout was accelerated when the Dräger Fabius GS was equipped with autoclaved components, the reduction in washout time may be less than that required for this technique to be accepted into clinical practice. A dedicated vapor-free workstation may be preferable for rapid turnover between cases.
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The purpose of this narrative review is to describe an anatomical approach for residents-in-training and anesthesiologists who are learning techniques of ultrasound-guided regional anesthesia of the neck and upper limb. ⋯ Simple sonographic anatomical patterns can provide a strategy to correctly locate nerves when performing ultrasound-guided cervical and brachial plexus anesthesia.