Anaesthesia and intensive care
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Outcome has been measured for 6000 consecutive procedures in a major public teaching hospital day surgery unit. The unanticipated hospital admission rate was 1.34% and surgery-related admissions (0.95%) exceeded those related to anaesthesia (0.13%). Perioperative complications related to surgery (1:105) were more frequent than those related to anaesthesia (1:176) and pre-existing medical problems (1:500). ⋯ At early follow-up, 4.0% of patients had presented to a local medical practitioner and 3.1% to a hospital accident and emergency service, usually for minor problems. Take home analgesia was adequate for 95% of patients and 98.9% were happy with the day surgery service. Day surgery in a teaching hospital can provide satisfactory outcome, with low complication rates, high patient acceptance and low community support requirements after patient discharge.
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Anaesth Intensive Care · Dec 1993
Randomized Controlled Trial Comparative Study Clinical TrialCombined epidural and general anaesthesia versus general anaesthesia for abdominal aortic surgery: a prospective randomised trial.
Fifty patients undergoing elective abdominal aortic surgery were randomised to receive either combined epidural and general anaesthesia and postoperative epidural analgesia (CEGA) or general anaesthesia and postoperative intravenous morphine infusion (GA). Prospective data was collected in order to compare the two groups. This included intraoperative cardiovascular changes and postoperative complications. ⋯ Two patients in the CEGA group died postoperatively compared to one in the GA group (not significant). There was no significant difference between groups in the total number or type of postoperative complications. Combining epidural anaesthesia with general anaesthesia altered intraoperative cardiovascular management but did not affect postoperative outcome.
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Anaesth Intensive Care · Dec 1993
Randomized Controlled Trial Clinical TrialWarm local anaesthetic--effect on latency of onset of axillary brachial plexus block.
A double-blind, controlled trial was conducted to determine whether warming local anaesthetic reduces the onset time of axillary brachial plexus block. Forty patients were randomised into two groups. ⋯ A solution of 40 ml of lignocaine 1.5% with adrenaline 1:200,000 was used for all patients. Warming the local anaesthetic was not demonstrated to reduce the latency of onset of blockade.
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Anaesth Intensive Care · Dec 1993
Randomized Controlled Trial Clinical TrialArterial desaturation during induction with and without preoxygenation: evaluation of four techniques.
The incidence and degree of hypoxaemia during induction of balanced anaesthesia and endotracheal intubation were studied prospectively in 80 healthy adults undergoing elective surgery randomly divided into four equal groups of 20. Group 1 was preoxygenated for three minutes. The other three groups were not preoxygenated. ⋯ Two patients in Group 3 and four in Group 4 had hypoxaemia. This incidence was not statistically significant. We conclude that ventilation with 100% oxygen for one minute prior to intubation and preoxygenation for three minutes are equally effective in preventing hypoxaemia during induction.
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Anaesth Intensive Care · Dec 1993
Randomized Controlled Trial Clinical TrialThe effects of providing preoperative statistical anaesthetic-risk information.
Are patients who are provided with details about anaesthesia risks on the eve of surgery better informed, and does the information increase their anxiety? Forty (ASA Class I or II) patients scheduled for surgery requiring general anaesthesia were randomly allocated to either a routine or a detailed information group. Levels of anxiety were assessed by the Spielberger State-Trait Anxiety Inventory. Actual knowledge of risks was assessed by a special visual analogue scale. ⋯ The detailed group, however, had gained more accurate knowledge of the likelihood of two rare complications, death (P < 0.001) and serious tooth damage (P < 0.05). Notwithstanding, there was no difference between the groups in anxiety. Thus, provision of detailed information about the risks of the complications of general anaesthesia did increase patients' knowledge but did not increase patients' levels of anxiety.