Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Sleep apnoea syndrome (SAS) is a relatively common, potentially fatal, disorder. Patients with SAS exhibit repetitive, often prolonged episodes of apnoea during sleep, with serious nocturnal and diurnal physiologic derangements. Several anecdotal reports and clinical studies have documented anaesthetic-related occurrence of fatal and near-fatal respiratory complications in these patients. The purpose of this article is to outline the potential problems encountered in anaesthetic management of adult SAS patients, and to suggest a practical approach for anaesthesia both for incidental and specific procedures. ⋯ Perioperative risks attending SAS patients emphasize the importance of their detection, perioperative evaluation and planning.
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Historical Article
Oropharyngeal and nasopharyngeal airways: I (1880-1995).
During the past decade the laryngeal mask airway (LMA) has dominated literature about airways for use during general anaesthesia. The LMA addresses clearly defined clinical objectives. The purpose of this study is to determine whether those objectives were described collectively with reference to earlier airway designs. ⋯ The design of airways has been based on clinical circumstances and perceived requirements of the time. In contemporary anaesthetic practice, distinct clinical situations still occur and there is a role for different device designs. Currently for supraglottic airway management during general anaesthesia, four types of airway should be available: a Guedel airway, nasopharyngeal airway, a laryngeal mask airway, and an airway specifically designed to facilitate blind tracheal intubation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Preoperative ketorolac increases bleeding after tonsillectomy in children.
To compare the incidence of vomiting following codeine or ketorolac for tonsillectomy in children. ⋯ Preoperative ketorolac increases perioperative bleeding among children undergoing tonsillectomy without beneficial effects.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of propofol versus thiopentone with midazolam or lidocaine to facilitate laryngeal mask insertion.
To assess the ease of insertion of laryngeal mask airway (LMA) comparing propofol with lidocaine or midazolam followed by thiopentone and compare the costs with each technique. ⋯ With the above doses, a fentanyl-midazolam-thiopentone combination which is about 35% less expensive than fentanyl-propofol, provides equally good conditions for the insertion of LMA.
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To describe the serum concentrations of ketamine following a clinically relevant dosing schedule during cardiopulmonary bypass (CPB). ⋯ This dosage regimen maintained general anaesthetic concentrations of ketamine throughout the operative period. These levels should result in brain tissue concentrations in excess of those previously shown to be neuroprotective in animals. Thus we conclude that this infusion regimen would be reasonable to be use in order to assess the potential neuroprotective effects of ketamine in humans undergoing CPB.