Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Previous studies have shown a decrease of lower oesophageal sphincter (LOS) tone during stimulation of the upper oesophageal sphincter. Therefore, we hypothesized that during anaesthesia, cricoid pressure could result in a decrease in LOS pressure. ⋯ This study shows that cricoid pressure decreases LOS tone in anaesthetized pigs. Although no gastrooesophageal reflux was recorded, this study suggests that, if cricoid pressure does not completely occlude the oesophagus, the decrease of oesophageal barrier pressure induced could favour the appearance of pulmonary aspiration.
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Randomized Controlled Trial Comparative Study Clinical Trial
Epidural analgesia for labour and delivery: fentanyl or sufentanil?
The highly lipid soluble opioids, fentanyl and sufentanil, are used in combination with local anaesthetics with/without epinephrine to provide epidural analgesia during labour and delivery. Our aim was to determine whether wither opioid was superior when used with low dose local anaesthetic. ⋯ Epidural opioid infusion with very low dose bupivacaine (0.015%) achieved an overall high level of patient satisfaction in both groups without serious maternal or neonatal side effects. At the fentanyl-to-sufentanil ratio used here patients receiving sufentanil had lower pain scores and substantially fewer patients required bupivacaine rescue.
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Randomized Controlled Trial Clinical Trial
[Effects of different doses of edrophonium antagonism of mivacurium-induced neuromuscular block in the presence of nitrous oxide, propofol, and alfentanil anesthesia].
The purpose of this study was to determine the dose-response relationships for edrophonium antagonism of mivacurium-induced neuromuscular block. ⋯ Edrophonium in doses of 0.1 mg.kg-1 and higher permitted faster recovery of all indices from a mivacurium-induced block during alfentanil-propofol-N2O anaesthesia than did placebo.
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Case Reports
Meningitis following a combined spinal-epidural technique in a labouring term parturient.
To report a case of probable bacterial meningitis in a parturient who received a combined spinal-epidural (CSE) technique for labour analgesia. ⋯ Meningitis may occur, albeit rarely, with any neuraxial blocks including CSE techniques. Early diagnosis and appropriate antibiotic therapy are important in preventing serious neurological sequelae.
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Case Reports
Unintentional intraoperative awareness during sufentanil anaesthesia for cardiac surgery.
The aim of this clinical report is to describe a case of unintentional intraoperative awareness during sufentanil anaesthesia in a patient undergoing elective aortocoronary bypass grafting. ⋯ Although awareness during opioid anaesthesia has been previously described with morphine and fentanyl, as far as we know this is the first clinical report of awareness with sufentanil. Given that recent efforts of early extubation in cardiac surgery patients may involve a reduction in the amount of opioid administered, this report serves as a reminder of the ever present potential for this disturbing complication.