Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Ambulatory office-based anesthesia (OBA) is a relatively new but rapidly growing field. OBA requires a different approach than that used in the hospital, because there are unique considerations that must be recognized when administering anesthesia in a free-standing office facility. This review provides a summary of the important issues and aspects of safe patient care. ⋯ Appropriately so, an increasing number of provinces (Canada) and states (US) are beginning to regulate office-based facilities and require accreditation.
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Randomized Controlled Trial
Insertion of the ProSeal laryngeal mask airway is more successful with the 90 degrees rotation technique.
The 90 degrees rotation technique for inserting the ProSeal laryngeal mask airway (PLMA) in anesthetized paralyzed patients was compared with the index finger insertion technique. ⋯ The 90 degrees rotation technique for inserting the PLMA is more successful than the standard index finger insertion technique. It is associated with fewer side effects, such as blood on the PLMA and sore throat, which suggests it causes less pharyngeal trauma.
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Myotonic dystrophy type 2 (DM2) is a genetically distinct disorder that shares some phenotypical features of myotonic dystrophy type 1 (DM1). However, anesthetic management of patients with DM2 has not been described. The purpose of this study is to report the anesthetic management of a series of patients with DM2 and to describe their response to anesthesia. ⋯ In our series, patients with DM2 tolerated commonly used anesthetics without obvious complications, and they exhibited normal responses to muscle relaxants. These observations suggest that these medications may be used safely in patients with DM2.
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Randomized Controlled Trial
Orogastric tubes do not improve transesophageal echocardiographic imaging during cardiac surgery: a randomized trial.
Image quality is often an overlooked consideration that affects the quality and findings of a perioperative transesophageal echocardiography (TEE) study. We undertook a study to evaluate the potential benefit of orogastric (OG) tube insertion following tracheal intubation as a method to improve TEE image quality. ⋯ While this study was underpowered to detect small changes in image quality, the use of an OG tube for routine cases did not improve the overall quality of the related images acquired during TEE examination.