Anaesthesia and intensive care
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Anaesth Intensive Care · Feb 2002
Randomized Controlled Trial Comparative Study Clinical TrialDiclofenac or paracetamol for analgesia in paediatric myringotomy outpatients.
This prospective, randomized, double-blind study compared the analgesic efficacy of oral diclofenac resinate 0.5 mg.kg(-1) with paracetamol 15 mg/kg(-1) for control of postoperative pain in paediatric patients for outpatient bilateral myringotomy and tube insertion. Paracetamol, the most commonly used oral analgesic for paediatric patients, was compared with a new palatable syrup formulation of diclofenac. Sixty-three ASA 1 orA SA 2 children aged one year and above were randomly assigned to receive diclofenac (Group A) or paracetamol (Group B). ⋯ Overall, CHEOPS scores were low for both groups at all times and did not differ between the groups at any time. Twenty per cent of the diclofenac group and 27% of the paracetamol group required rescue analgesia (not statistically significant). The efficacy of diclofenac 0.5 mg x kg(-1) and paracetamol 15 mg x kg(-1) as oral analgesic premedication for BMT was comparable in children receiving an anaesthetic which included intraoperative administration of fentanyl 1 microg x kg(-1).
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Anaesth Intensive Care · Feb 2002
Randomized Controlled Trial Clinical TrialDetection and correction of accidental oesophageal intubation during flexible lightwand-guided intubation via the intubating laryngeal mask.
In the following two-part study, we determined the efficacy of observation of the light glow to detect correct placement of the tracheal tube after lightwand-guided tracheal intubation via the intubating laryngeal mask (ILM). We also determined the efficacy of a protocol to correct oesophageal intubation in this situation. In study 1, 80 ASA 1-3, anaesthetized, paralysed patients were randomly assigned to have a tracheal tube, preloaded with a flexible lightwand, placed into either the trachea (n=40) or oesophagus (n=40) under laryngoscope guidance. ⋯ In 40/55 (73%) patients, tracheal intubation was successful at the second attempt and in 13/55 (24%) at the third or fourth attempt. In 2/55 (4%) patients, persistent oesophageal intubation occurred. The sensitivity, specificity and positive predictive value were 95%, 92.5% and 92.7% respectively in study 1, and were all 100% in study 2.