Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial
Intracuff 160 mg alkalinized lidocaine reduces cough upon emergence from N2O-free general anesthesia: a randomized controlled trial.
Chemical and mechanical irritation of the tracheal mucosa influences the incidence of cough at emergence from general anesthesia, potentially leading to significant postoperative complications. This study evaluates the benefits of endotracheal tube (ETT) intracuff alkalinized lidocaine during N2O-free general anesthesia by 1) assessing the in vitro effect of alkalinization on lidocaine diffusion kinetics across the cuff's membrane and 2) evaluating, in a randomized controlled clinical trial, the impact of 160 mg of intracuff alkalinized lidocaine on cough upon emergence from anesthesia for surgery lasting > 120 min. ⋯ The use of 160 mg of intracuff alkalinized lidocaine is associated with a decreased incidence of cough upon emergence from N2O-free general anesthesia > 120 min. This trial was registered at www.clinicaltrials.gov (NCT01774292).
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Randomized Controlled Trial
Performing post-tetanic count during rocuronium blockade has limited impact on subsequent twitch height or train-of-four responses.
Waiting five to six minutes before measuring a train-of-four (TOF) after a 50-Hz tetanic stimulation or post-tetanic count (PTC) in order to allow the facilitation of transmission to subside is commonly recommended but is based on limited evidence. The purpose of this study was to measure the TOF responses after PTC in one hand and to compare the responses with those in the contralateral (control) hand. ⋯ A small but clinically insignificant increase in T1 is seen for at least ten minutes after PTC without any detectable change in T4/T1 values. The TOF responses are reliable as early as one minute after PTC.
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Comparative Study
Safety and comparative costs of preoperative assessments for cataract surgery: traditional mandatory assessment versus a novel graded assessment system.
We conducted this study to evaluate the safety and costs of traditional mandatory preoperative assessment for cataract surgery patients compared with a novel graded preoperative assessment system. ⋯ The graded system resulted in no major complications and a low rate of minor complications. The information obtained from the mandatory assessment is unlikely to prevent complications. Additionally, the cost effectiveness of the mandatory system was poor. This novel graded preoperative assessment system for cataract surgery patients can save time and resources by eliminating unnecessary patient visits.
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Amniotic fluid embolism is always a severe complication and generally occurs during labour or immediately after childbirth. ⋯ Amniotic fluid embolism is a rare and difficult diagnosis, especially in unconventional settings, yet it can be facilitated by screening for amniotic markers and tryptase.