Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial
Intravenous lidocaine does not reduce length of hospital stay following abdominal hysterectomy.
Intravenous lidocaine given both intraoperatively and postoperatively decreases pain scores, reduces opioid consumption, and promotes faster return of bowel function following abdominal surgery. The purpose of this trial was to determine if intravenous lidocaine limited to the intraoperative period reduces length of hospital stay and improves functional recovery following abdominal hysterectomy. ⋯ Intraoperative administration of intravenous lidocaine did not reduce hospital stay or improve objective measures of analgesia and recovery following abdominal hysterectomy. This trial was registered at ClinicalTrials.gov (NCT00382499).
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Randomized Controlled Trial
Topical lidocaine reduces the risk of perioperative airway complications in children with upper respiratory tract infections.
To determine the effect of topically applied lidocaine on perioperative airway complications when using a laryngeal mask airway device (LMAD) in children either with or without a history of recent or ongoing upper respiratory tract infection (URI). ⋯ Lubrication of the LMAD with lidocaine gel reduces the incidence of airway complications in children with an upper respiratory tract infection.
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Randomized Controlled Trial
When are parents helpful? A randomized clinical trial of the efficacy of parental presence for pediatric anesthesia.
To examine the utility of parental presence to alleviate anxiety in a narrow age range of children undergoing outpatient surgery. We hypothesized that parental presence would lower anxiety scores as measured by the modified Yale Preoperative Anxiety Scale (mYPAS) at two time-points during pediatric outpatient surgery, i.e., separation from parents and placement of the face mask for anesthetic induction. ⋯ Our results suggest that anxiety levels in children undergoing day surgical procedures differ as a function of parental presence at the point when children are separated from parents. Future research should examine the types of interactions that occur during this time-point that may explain this finding.
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High volume tubing is used to deliver carbon dioxide during laparoscopic procedures. Failure to prime the tubing with carbon dioxide prior to abdominal insufflation may result in the delivery of nitrogen-containing air to the abdominal cavity. We report a case in which initial insufflation of laparoscopic gas resulted in immediate cardiovascular collapse requiring prolonged resuscitation. Persistent intracranial emboli following the arrest may have resulted from nitrogen contamination of the delivered gas. ⋯ Persistence of emboli following endoscopic procedures suggests that the entrained gas is insoluble. Room air contamination increases the potential for catastrophic events during laparoscopy and other endoscopic procedures.
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The outcome of patients with preoperative renin-angiotensin system (RAS) blockade, achieved either by angiotensin converting enzyme inhibitors or angiotensin receptor blocking agents, was assessed using 30-day mortality as a primary end point. ⋯ Examination of 883 cases of AAA repair showed increased mortality associated with preoperative RAS blockade. A better understanding of perioperative pharmacology and physiology of RAS blockade is needed as well as future studies to identify causality.