European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study
Comfort of the patient during axillary blocks placement: a randomized comparison of the neurostimulation and the ultrasound guidance techniques.
Axillary brachial plexus block under neurostimulation is commonly used for upper limb surgery, but it is sometimes recognized as an uncomfortable technique, with most patients identifying electrical stimulation as an unpleasant moment. Ultrasound-guided regional anaesthesia, which becomes an increasingly popular technique, does not require electrical stimulation and then should theoretically improve axillary block placement comfort. The aim of this study was to compare the comfort of the patients during axillary block placement with neurostimulation and ultrasound guidance using either the out-of-plane or the in-plane approach. ⋯ The present study showed that the ultrasound approaches were less painful and more comfortable than neurostimulation to place axillary blocks. We also showed that, although pain intensity resulting from blocks placement was similar with the ultrasound approaches, very comfortable procedures were more frequent with the out-of-plane than with the in-plane approach.
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Case Reports
Late intravascular migration of a previously well functioning labour epidural catheter.
Intravascular epidural catheters may result in insufficient labour analgesia or can produce potentially lethal complications following an epidural top-up. We report a case of a previously well functioning epidural catheter positioned epidurally using a combined spinal epidural anaesthesia technique, which subsequently was found to be intravascular. The literature is reviewed.
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Comparative Study
Comparison of a bupivacaine peripheral nerve block and systemic ketoprofen on peripheral inflammation and hyperalgesia in rats.
Local anaesthetics via a nerve block can attenuate inflammation. However, their effects have never been compared with the anti-inflammatory effects of systemic NSAIDs. The aim of this study was to compare the effects of bupivacaine via sciatic block with a systemic NSAID on oedema and hyperalgesia and on indices of systemic inflammation as measured by cytokines and prostaglandin E2 production in a model of peripheral inflammation in rats. ⋯ In the current study, a bupivacaine block alone achieved the same anti-inflammatory effect as systemic NSAID or as when the same block is combined with a NSAID.
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Randomized Controlled Trial Comparative Study
Safety and efficacy of laryngeal mask airway Supreme versus laryngeal mask airway ProSeal: a randomized controlled trial.
The Supreme laryngeal mask airway (LMA) is a new single-use polyvinyl chloride supraglottic device that combines the functionality of the ProSeal and Fastrach airways. High oropharyngeal leak pressures are important as they indicate airway protection, feasibility of positive pressure ventilation and likelihood of successful LMA placement. The oropharyngeal leak pressure of the LMA Supreme is not well established versus the LMA ProSeal. This study was designed to compare the safety and efficacy of the LMA Supreme versus the LMA ProSeal in elective ambulatory procedures. ⋯ The LMA Supreme has lower oropharyngeal leak pressures than the LMA ProSeal. The success of the first attempt insertion was higher for the LMA Supreme. The LMA Supreme is a safe, efficacious and easy-to-use disposable supraglottic airway device in elective ambulatory procedures. The higher rate of success on first attempt insertion may make it more suitable as an airway rescue device.