Irish journal of medical science
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Randomized Controlled Trial
Obturator nerve block transurethral surgery for bladder cancer: comparison of inguinal and intravesical approaches: prospective randomized trial.
Transurethral resection of bladder tumors close to these areas may stimulate the obturator nerve, causing violent adductor contraction and possible inadvertent bladder perforation. To avoid this reaction, local anesthetic blockade of the obturator nerve as it passes through the obturator canal is effective in stopping adductor spasm during spinal anesthesia. ⋯ Obturator nerve block plays an additive role on the quality of analgesia for bladder surgery. Our data suggests that identification of the obturator nerve with ultrasound is easy and the block can be assessed by observing avoidance of bladder spasm.
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Randomized Controlled Trial Comparative Study
Propofol-ketamine combination: a choice with less complications and better hemodynamic stability compared to propofol? On a prospective study in a group of colonoscopy patients.
In this study, we compared duration for reaching desired Ramsay Sedation Score (RSS) and postoperative recovery according to Modified Aldrete Score (MAS) of propofol and propofol-ketamine combination in a group of colonoscopy patients. Rates of cardiovascular, respiratory, laryngospasm, visual and nausea/vomiting complications were also compared as secondary outcomes. ⋯ Propofol-ketamine combination is an advantageous choice in means of achieving sedation in a shorter period of time, a better hemodynamic stability, less nausea and vomiting and respiratory complication rates. Yet it seems that this choice might be related with longer recovery duration.
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A positive learning environment in which postgraduate doctors are supported, supervised and nurtured, is likely to lead to enhanced professional satisfaction and improved patient care. ⋯ Recommendations stemming from this study should lead to improvements in the quality of the educational environment of junior doctors and may stimulate similar evaluations in other teaching hospitals.
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Randomized Controlled Trial Comparative Study
Comparison of GlideScope video laryngoscopy and Macintosh laryngoscope in ear-nose and throat surgery.
Endotracheal intubation procedure employed during general anaesthesia is the most effective way for keeping the airways and respiration under control and has low risk of complications. We have aimed in this study to compare the first-attempt success and duration of the endotracheal intubation process and its effects on haemodynamics using the Macintosh laryngoscope and the GlideScope video laryngoscope. ⋯ In our study, despite the longer intubation times in group G, the haemodynamic response was significantly lower in this group. It is believed that especially in cases with vital requirement of haemodynamic stability, the GlideScope video laryngoscope would be safer to employ.