European journal of anaesthesiology
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Comment Letter Randomized Controlled Trial Clinical Trial
Tropisetron or ondansetron for the prevention of post-operative nausea and vomiting (PONV)
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We compared the performance of the size 5 laryngeal mask airway in 20 paralysed anaesthetized male patients and 20 male cadavers (6-24 h post-mortem). Groups were matched for height and weight. Airway sealing pressure, in vivo intracuff pressure and anatomical position (judged fibre-optically) were documented at zero volume and after each additional 10 mL up to 40 mL. ⋯ There were no differences in airway sealing pressure, in vivo intracuff pressure or fibre-optic position between the groups. We conclude that the performance of the laryngeal mask airway is similar for fresh cadavers and paralysed anaesthetized patients. This may have implications for laryngeal mask airway research and training.
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Nucleoside analogue-induced lactic acidosis is an often fatal condition in patients with HIV. There is only one report of successful treatment with riboflavin. ⋯ Successful treatment of nucleoside analogue-induced lactic acidosis with a high dose of thiamine supports the hypothesis that vitamin deficiency is an important cofactor in the development of this rare and unpredictable condition in patients with HIV. We suggest that high dose B-vitamins should be given to any patient presenting with lactic acidosis under nucleoside analogue treatment.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of intra-articular fentanyl and intra-articular bupivacaine for post-operative pain relief after knee arthroscopy.
A randomized double-blinded study consisting of 107 patients was conducted to compare the effect on post-operative pain relief of intra-articular fentanyl and intra-articular bupivacaine after knee arthroscopy. The results showed that intra-articular bupivacaine produced superior analgesia in the immediate post-operative period. ⋯ After 2 h post-operatively, intra-articular bupivacaine and intra-articular fentanyl had a similar effect on pain scores. The mean pain score 18 h post-operatively was 2.7 for the intra-articular bupivacaine group (standard deviation 2.2, P value 0.6) compared with the intra-articular fentanyl group which had a mean pain score of 2.8 (standard deviation 1.9, P value 0.6).
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Optimal control of long-term sedation during therapy in the intensive care unit is difficult to achieve in a number of patients when based on commonly used clinical sedation scores alone. We therefore used the median frequency of the EEG power spectrum as a quantitative measure for closed-loop administration of propofol in 21 artificially ventilated patients (nine trauma, 12 non-trauma). ⋯ Non-trauma patients required sedation with an EEG median frequency between 2 and 3 Hz (propofol consumption: 1.4 +/- 0.8 mg kg-1 h-1) and sedation seemed to follow some circadian patterns, whereas trauma patients needed significantly deeper sedation (EEG median frequency: 1-2 Hz; propofol consumption: 2.6 +/- 0.8 mg kg-1 h-1). We conclude that the EEG closed-loop system could safely and reliably administer propofol to maintain a predetermined level of sedation for patients in intensive care unit over a protracted time.