Anaesthesia and intensive care
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Anaesth Intensive Care · Jan 2011
Randomized Controlled TrialEffect of intravenous ondansetron on sensory and motor block after spinal anaesthesia with hyperbaric bupivacaine.
Ondansetron is a potent antiemetic and a competitive antagonist at serotonin receptors, which are also involved in modulation of pain. This study was designed to assess the effect of systemic ondansetron on sensory and motor block after subarachnoid anaesthesia with hyperbaric bupivacaine. Sixty patients undergoing transurethral resection of bladder tumours were randomly assigned to one of two groups. ⋯ No differences in regression of sensory block were noted at any time. The mean duration of motor block also did not differ (P = 0.44), with similar regression of block at all time intervals except at 90 minutes. We concluded that intravenous ondansetron does not affect the intensity or duration of sensory and motor block after spinal anaesthesia with hyperbaric bupivacaine.
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Anaesth Intensive Care · Jan 2011
Randomized Controlled TrialThe effects of positive or negative words when assessing postoperative pain.
Negative or harsh words such as 'pain' and 'sting' used to describe sensations prior to potentially painful procedures have been shown to increase pain. We aimed to determine whether the reporting of pain and its severity is affected by the way it is assessed during anaesthesia follow-up after caesarean section. Following caesarean section, 232 women were randomised prior to post-anaesthesia review. ⋯ The assessment of pain after caesarean section, using more positive words, decreases its incidence but does not affect its severity when measured by pain scores. Words that focus the patient on pain during its assessment may lead some to interpret sensations as pain which they might not do otherwise. These findings may have important implications when assessing and researching postoperative pain.
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Anaesth Intensive Care · Nov 2010
Randomized Controlled Trial Comparative StudyA comparison of low dose hyperbaric levobupivacaine and hypobaric levobupivacaine in unilateral spinal anaesthesia.
The aim of this study was to compare the clinical effects and characteristics of hyperbaric and hypobaric levobupivacaine for unilateral spinal anaesthesia. Sixty patients were randomly allocated into two groups to receive either 7.5 mg (1.5 ml) hyperbaric levobupivacaine 0.5% or 7.5 mg (4 ml) hypobaric levobupivacaine 0.1875% for elective arthroscopic surgery of the knee under spinal anaesthesia. The level and duration of sensory block, intensity and duration of motor block were recorded. ⋯ In the hyperbaric group, the motor block scores were higher on the operative side during first 10 minutes than they were in the hypobaric group (P < 0.002). Motor block regression was faster in the hyperbaric group (P = 0.01). Hyperbaric and hypobaric levobupivacaine both provided satisfactory unilateral spinal anaesthesia with good haemodynamic stability for arthroscopic surgery, but with more frequent unilateral spinal anaesthesia in the hyperbaric group.
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Anaesth Intensive Care · Nov 2010
Randomized Controlled Trial Comparative StudyRandomised comparison of the LMA Supreme with the I-Gel in spontaneously breathing anaesthetised adult patients.
We compared the performance of the LMA Supreme (SLMA) with the I-Gel during anaesthesia in spontaneously breathing adult patients. Ninety patients with American Society of Anesthesiologists physical status I or II were studied in a prospective randomised controlled study. Our primary outcome measure was oropharyngeal leak pressure. ⋯ The incidence of complications was low in both groups. The grade of fibreoptic view was better with the I-Gel than the SLMA (P = 0.001). We conclude that in adults with normal airways, the SLMA is easier to insert and provides a higher oropharyngeal leak pressure, but fibreoptic views are better with the i-gel.
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Anaesth Intensive Care · Sep 2010
Randomized Controlled Trial Comparative StudyRemifentail infusion for paediatric bronchoscopic foreign body removal: comparison of sevoflurane with propofol for anaesthesia supplementation for bronchoscope insertion.
The study compared sevoflurane or propofol as anaesthesia supplements to remifentanil infusion and topical local anaesthesia for insertion of a rigid bronchoscope for bronchial foreign body removal in children aged one to three years. Seventy children were randomly allocated to two groups to receive remifentanil infusion at 0.2 microg x kg(-1) x min(-1) with either sevoflurane or propofol supplements for insertion of the rigid bronchoscope. Heart rate and systolic blood pressure before anaesthesia, prior to and on insertion of the bronchoscope and one, three, five, seven and ten minutes after insertion were measured. ⋯ The sevoflurane group had a lower incidence of cough than the propofol group. No significant difference was detected in the incidence of apnoea between groups. It can be concluded that remifentanil infusion with modest use of general anaesthetic agents facilitates rigid bronchoscopy successfully in children.