European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study
Comparison of sevoflurane volatile induction/maintenance anaesthesia and propofol-remifentanil total intravenous anaesthesia for rigid bronchoscopy under spontaneous breathing for tracheal/bronchial foreign body removal in children.
Foreign body aspiration is a life-threatening condition, with children under 3 years of age most at risk. This study was designed to compare the clinical characteristics of sevoflurane volatile induction/maintenance anaesthesia (VIMA) and propofol-remifentanil total intravenous anaesthesia (TIVA) for children undergoing rigid bronchoscopy under spontaneous breathing for tracheal/bronchial foreign body removal. ⋯ Compared with propofol-remifentanil TIVA, sevoflurane VIMA provides more stable haemodynamics and respiration, faster induction and recovery and higher incidence of excitement in paediatric patients undergoing tracheal/bronchial foreign body removal under spontaneous breathing.
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Randomized Controlled Trial Comparative Study
Postoperative efficacies of femoral nerve catheters sited using ultrasound combined with neurostimulation compared with neurostimulation alone for total knee arthroplasty.
Neurostimulation is commonly used to perform femoral nerve block. Ultrasound can be used to identify nerve structures and guide needle placement. The aim of this study was to compare postoperative analgesic efficiency when femoral nerve catheters were sited using ultrasound (in-plane approach) combined with neurostimulation or neurostimulation alone, for total knee arthroplasty. ⋯ Continuous perineural femoral catheter placement using ultrasound combined with neurostimulation and an in-plane approach reduces total doses of local anaesthetic, morphine consumption and improves postoperative pain management by comparison with neurostimulation alone.
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Randomized Controlled Trial
Flumazenil expedites recovery from sevoflurane/remifentanil anaesthesia when administered to healthy unpremedicated patients.
To investigate the hypothesis that 0.3 mg flumazenil administered to healthy unpremedicated patients at the end of deep surgical sevoflurane/remifentanil anaesthesia would expedite recovery. Flumazenil, an imidazobenzodiazepine derivative, antagonizes the hypnotic/sedative effects of benzodiazepines on γ-aminobutyric acid receptors. However, endogenous benzodiazepine ligands (endozepines) were isolated in mammalian tissues of individuals who had not received benzodiazepines. ⋯ Administration of a single dose of 0.3 mg flumazenil to healthy unpremedicated patients at the end of sevoflurane/remifentanil anaesthesia results in earlier emergence from anaesthesia and significantly expedites recovery. This could redefine the role of flumazenil in general anaesthesia, implicating endozepine-dependent mechanisms.
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Randomized Controlled Trial Comparative Study
Comparison of TruView EVO2 with Miller laryngoscope in paediatric patients.
Except for neonates and specific malformations in children, management of the paediatric airway is not a major problem for the anaesthetist. Miller laryngoscope was traditionally used for paediatric intubation. The TruView EVO2 system is a recently introduced device with a unique blade that provides a wide and magnified laryngeal view. ⋯ The results suggest that when compared with the Miller laryngoscope, the TruView EVO2 laryngoscope appears to improve the view of the larynx but requires a longer time for tracheal intubation. The IDS scores were similar; thus, the TruView EVO2 laryngoscope can be a good alternative to traditionally used Miller laryngoscope.
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Randomized Controlled Trial Comparative Study
Reinforced laryngeal mask airway compared with endotracheal tube for adenotonsillectomies.
The endotracheal tube (ETT) has traditionally been considered the best airway device during adenotonsillectomy because a well protected and secured airway is provided. This has been challenged by the introduction of the reinforced laryngeal mask airway (RLMA). It does not kink, is less traumatic during insertion and better tolerated during emergence. The purpose of this study was to compare the use of the RLMA with ETT with regards to postoperative pain, nausea, vomiting and perioperative efficacy in a series of children due for adenotonsillectomy. ⋯ The RLMA, when feasible, is a well tolerated and effective alternative to the ETT for use during adenotonsillectomies in children, with beneficial effects on airway irritations, operating room efficiency and early postoperative pain.