European journal of anaesthesiology
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Failed intubation is an important cause of anaesthetic-related maternal mortality. The purpose of this study was to determine the ability to predict difficult visualization of the larynx from the following preoperative airway predictive indices, in isolation and combination: modified Mallampati test, the ratio of height to thyromental distance and the Upper-Lip-Bite test. ⋯ The ratio of height to thyromental distance may prove a useful screening test for predicting difficult laryngoscopy in obstetric population.
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Randomized Controlled Trial Comparative Study
Bronchial mucus transport velocity in patients receiving desflurane and fentanyl vs. sevoflurane and fentanyl.
Sevoflurane has been shown to distinctly reduce bronchial mucus transport velocity, an essential determinant of mucociliary clearance and pulmonary complications. However, sevoflurane is regarded as one of the least irritant volatile anaesthetics, especially when compared with desflurane. Hence, the aim of this double-blind, randomized, controlled trial was to assess differences in bronchial mucus transport velocity between sevoflurane and desflurane. ⋯ Desflurane is commonly regarded as more irritant to the airway, but as far as bronchial mucus transport velocity is concerned, the choice between sevoflurane and desflurane does not seem to matter.
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Combined spinal epidural analgesia is effective for fast relief of severe labour pain but has been associated with worrisome decreases in fetal heart rate. Since the reasons for this phenomenon remain elusive, some anaesthesiologists may abstain from using this technique. We postulated that factors unrelated to the neuraxial technique could play a role in the decrease in fetal heart rate. To our knowledge, no prospective study has previously looked into this possibility. ⋯ Maternal pain scores and older maternal age are factors unrelated to the neuraxial technique that are independent predictors of fetal bradycardia after neuraxial analgesia for labour.
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Letter Randomized Controlled Trial Comparative Study
Intraoperative epidural analgesia does not reduce time of postoperative analgesic treatment compared to intravenous analgesia.