Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Letter Case Reports
Spinal anaesthesia for caesarean section in a patient with brain neoplasma.
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The popularity of the Residents' Competition at the annual meeting of the Canadian Anaesthetists' Society inspired this 25 yr review of the competitors and their presentations. Data were collected from a questionnaire survey of all participants and all current Anaesthesia programme directors, review of the Canadian Anaesthetists' Society records, and a Medline data-base search. ⋯ Over half of all the presentations (53.1%) subsequently were published as scientific papers, and 71.7% of all participants practised anaesthesia in an academic environment at some point in their career. The Residents' Competition appears to have been successful in encouraging scientific excellence in physician's training in anaesthesia in Canada.
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Editorial Comment
Respiratory depression with patient-controlled analgesia.
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Randomized Controlled Trial Clinical Trial
Duration of decubitus position after epidural blood patch.
Thirty patients presenting with post-dural puncture headache (PDPH) were prospectively studied to determine the influence of the duration of the decubitus position after epidural blood patch on the efficacy of treatment. All patients received 12 ml of autologous blood. They were randomly distributed into three groups of ten patients. ⋯ The severity of PDPH in the three groups was reduced at the time of initially adopting a standing position and after 24 hr, in comparison with preblood patch VAS (P < 0.001). Patients in Group 3 presented less severe PDPH than patients in Group 1 at the time of initially standing up and 24 hr later (P < 0.05). We conclude that epidural blood patch was effective in treating PDPH but that the maintenance of a decubitus position for at least one hour and preferably for two hours after the blood patch was more effective than maintenance for 30 min.
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Randomized Controlled Trial Clinical Trial
Recovery of neuromuscular function after atracurium and pancuronium maintenance of pancuronium block.
The study was undertaken to determine whether a neuromuscular blockade induced with pancuronium but maintained with atracurium was associated with a shorter time to complete recovery after administration of neostigmine than if the blockade was maintained with pancuronium alone. Anaesthesia consisted of thiopentone, N2O/O2/enflurane and fentanyl, and the neuromuscular blockade, induced by pancuronium 0.1 mg.kg-1 was monitored by the force of contraction of adductor pollicis during major abdominal surgery lasting 2-5 hr. In 24 patients--Group 1--atracurium 0.07 mg.kg-1 was repeated when the first twitch of the train-of-four (TOF) returned to 25% of control (T1/TC 25). ⋯ The time from injection of the reversal drugs to a TOF ratio of 70% was similar in both groups (Group 1, 11.6 +/- 7.6 min; Group 2, 10.1 +/- 6 min; P = NS), but the recovery index was smaller in Group 2 (Group 1, 4 +/- 2.6 min; Group 2, 2.61 +/- 1.2 min; P < 0.05). Furthermore, there was no difference between groups in the duration of action of each redose. The study showed that when compared with pancuronium, equipotent doses of atracurium were not associated with (a) a shorter time to complete recovery from a neuromuscular blockade induced with pancuronium or (b) a shorter duration of action.