Anaesthesia and intensive care
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Anaesth Intensive Care · Nov 2009
Randomized Controlled Trial Comparative StudyContinuous intra-articular infusion of ropivacaine after unilateral total knee arthroplasty.
Intra-articular infusion of local anaesthetic after joint arthroplasty is attractive in that it is simple and will not cause motor block. However the efficacy of the technique has yet to be established. We enrolled 66 patients scheduled for unilateral total knee arthroplasty under general anaesthesia and single-shot femoral and sciatic nerve blocks. ⋯ There were two cases of infection, both in the treatment groups. No positive benefit of intra-articular infusion of local anaesthetic after total knee arthroplasty could be identified. On the contrary there may be negative effects in terms of expense, pain and possibly infection risks.
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Anaesth Intensive Care · Nov 2009
Randomized Controlled Trial Comparative StudyComparison of equipotent doses of ropivacaine-fentanyl and bupivacaine-fentanyl in spinal anaesthesia for lower abdominal surgery.
The aim of this randomised, double-blind study was to compare equipotent doses of plain ropivacaine and bupivacaine (19.5 mg and 13 mg respectively), both with fentanyl 20 microg, for spinal anaesthesia in lower abdominal surgery. After written informed consent had been obtained, 52 ASA I to II male patients scheduled for lower abdominal surgery were randomly assigned to receive intrathecal plain ropivacaine 19.5 mg with fentanyl 20 microg (group R, n =26) or plain bupivacaine 13 mg with fentanyl 20 microg (group B, n =26) in 3 ml. The level and duration of sensory block, intensity and duration of motor block, time to mobilise and patient satisfaction were recorded. ⋯ The duration of motor block (Bromage score >0) was shorter in group R (139+/-39 minutes vs group B 182+/-46 minutes, P <0.05). The duration and intensity of complete motor block (Bromage score=3) were also shorter in group R (90+/-25 minutes vs 130+/-40 minutes, P <0.05). We conclude that plain ropivacaine 19.5 mg plus fentanyl 20 microg is associated with a lower level of sensory block and a shorter duration of motor block when compared to bupivacaine 13 mg plus fentanyl 20 microg for spinal anaesthesia in lower abdominal surgery.
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Anaesth Intensive Care · Nov 2009
Randomized Controlled Trial Comparative StudyA randomised, single-blind, controlled trial of silicone disposable laryngeal masks during anaesthesia in spontaneously breathing adult patients.
We hypothesised that two new silicone disposable laryngeal mask airways, Meditech Systems Limited (MSL) and ProAct (PA), would perform similarly to the Classic Laryngeal Mask Airway (cLMA) in spontaneously breathing adult patients. One hundred and twenty consecutive adult patients were prospectively enrolled and randomly allocated to one of three groups (PA, MSL, cLMA). All patients received a standardised anaesthetic and insertion technique. ⋯ There was no statistical difference in airway sealing pressures between the PA laryngeal mask airway (17.9+/-5.9 cmH2O), MSL laryngeal mask airway (18.5+/-6.9 cmH2O,) and cLMA (17.6+/-5.6 cmH2O) (P=0.816). There was no statistical difference in insertion times, ease of insertion, cuff pressure and cuff volumes. The MSL and PA disposable laryngeal mask airways provided comparable airway sealing pressures to the reusable cLMA.