Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Review Meta Analysis Comparative Study
The effects of intranasal dexmedetomidine premedication in children: a systematic review and meta-analysis.
Intranasal dexmedetomidine premedication is a newly introduced method for reducing stress and anxiety before general anesthesia in children. We performed a meta-analysis to identify the effects of intranasal dexmedetomidine premedication in children. ⋯ Intranasal dexmedetomidine provided more satisfactory sedation at parent separation and reduced the need for rescue analgesics and the incidence of nasal irritation and postoperative nausea and vomiting when compared with other premedication treatments.
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Randomized Controlled Trial
Contribution of the nasal passage to face mask ventilation: a prospective blinded randomized crossover trial.
Previous studies have shown that the nasal passage plays an important role in manual face mask ventilation, but this has yet to be quantitatively assessed. We conducted a prospective randomized crossover clinical trial to compare the change in pressure-controlled face mask tidal volume with and without nasal airway occlusion. ⋯ Nasal passage obstruction considerably reduces tidal volume achieved during face mask ventilation. In some patients, it may be advantageous to relieve nasal airway obstruction for effective face mask ventilation.
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The accuracy of patient prognostication varies extensively in studies of select populations. Prognostication is an important component of patient selection for elective surgery. This retrospective study assessed patient prognostication prior to elective surgery by comparing the observed with the expected number of deaths in such patients. ⋯ The observed number of deaths within one year of elective surgery is significantly lower than expected, with minimal inter-surgeon variation. These results suggest that patient selection for major elective non-cardiac surgery identified individuals with better than expected survival and whose survival was not adversely influenced by their surgery.
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Although perioperative hypothermia may increase maternal morbidity, active warming is infrequently performed to maintain normothermia during Cesarean delivery (CD). The aim of this prospective observational study was to determine the factors associated with maternal hypothermia in this setting. ⋯ Several predictive factors for maternal hypothermia during CD were identified. These factors should be taken into account to help prevent maternal hypothermia during CD.