Anaesthesia and intensive care
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Anaesth Intensive Care · May 2009
Randomized Controlled Trial Comparative StudyEase of Proseal Laryngeal Mask Airway insertion and its fibreoptic view after placement using Gum Elastic Bougie: a comparison with conventional techniques.
The Proseal Laryngeal Mask Airway (PLMA) is routinely inserted by the digital and introducer tool techniques but a newer Gum Elastic Bougie (GEB) guided insertion technique has been described. The aims and objectives were to compare the ease of PLMA insertion and fibreoptic view of PLMA after placement using GEB and conventional techniques. Ninety-six ASA I or II patients of either gender aged 18 to 60 years, scheduled for elective surgery under general anaesthesia in the supine position were included in this study. ⋯ Time taken for successful placement was significantly shorter in the GEB-guided group after two attempts (G 22 +/- 2 seconds, I 31.9 +/- 18.8 seconds, D 29.5 +/- 18.6 seconds, P < 0.05). The fibreoptic view through the airway tube was significantly better in the GEB-guided group (P < 0.01). Incidence of trauma was significantly less in the GEB-guided group (P < 0.05).
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Anaesth Intensive Care · May 2009
Randomized Controlled Trial Comparative StudyRemifentanil-induced abdominal pain: a randomised clinical trial.
Remifentanil is an ultra-short-acting opioid, widely used for induction and maintenance of anaesthesia in various types of operations. We recently noted that a great number of patients receiving remifentanil in their anaesthetic regimen experienced postoperative abdominal pain. As a result, we performed this study to investigate its incidence. ⋯ Abdominal pain was observed in 79 patients (52.6%) in the remifentanil group, 10 of whom required a therapeutic intervention, but in only three patients in the control group, none of whom required an intervention (P value = 0.001). Postoperative nausea and vomiting were reported in seven and 10 patients (4.7%) in the remifentanil and control group, respectively. These findings indicate that abdominal pain is very common in patients receiving remifentanil by infusion for cataract surgery.
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Anaesth Intensive Care · May 2009
Randomized Controlled Trial Comparative StudySore throat or hoarse voice with bronchial blockers or double-lumen tubes for lung isolation: a randomised, prospective trial.
Double-lumen endotracheal tubes and bronchial blockers allow lung isolation for one-lung ventilation. Few studies, however, directly compare these devices. Further, a new endobronchial blocker (Coopdech) is available in some countries. ⋯ Compared to the double-lumen tubes the bronchial blockers took about two minutes less to position but five minutes longer for lung deflation. Surgical exposure was uniformly good across the four groups. We conclude that clinical use of the Coopdech endobronchial blocker is similar to the Arndt and Univent blockers and that all three are associated with less sore throat or hoarse voice than double-lumen tubes.
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Anaesth Intensive Care · May 2009
Randomized Controlled Trial Comparative StudyRelative efficiency of two warming devices during laparoscopic cholecystectomy.
Intraoperative hypothermia is a known consequence of general anaesthesia. Forced air warming devices are commonly used to prevent hypothermia in anaesthesia, but there are limited data on the use of radiant warming devices. Previous trials comparing the efficacy of forced air and radiant warming devices have reported discordant results. ⋯ Postoperative headache was recorded in four Sun-touch and no Warm-touch patients (P = 0.04). No difference in the efficacy of the Sun-touch warming device compared with the Warm-touch was demonstrated. Operational-mode side-effects may limit the use of the Sun-touch device.
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Anaesth Intensive Care · Mar 2009
Randomized Controlled Trial Comparative StudyA randomised, double-blind comparison of three different volumes of hypobaric intrathecal bupivacaine for orthopaedic surgery.
This study was designed to evaluate different doses of hypobaric 0.15% bupivacaine administered to achieve unilateral orthopaedic surgery under subarachnoid block. Using a randomised, double-blinded protocol, 150 ASA I to II patients scheduled for elective unilateral orthopaedic surgery were allocated to received a subarachnoid block with hypobaric bupivacaine 0.15% 4.5 mg (3 ml) (Group 1), 6.0 mg (4 ml) (Group 2) or 7.5 mg (5 ml) (Group 3). Measurements included cardiovascular and haemodynamic stability, incidence of unilateral anaesthesia, time to recover from motor block, postoperative urinary retention, transitory neurological symptoms and postdural puncture headache. ⋯ Seventy percent of patients had unilateral block. It was concluded that the spinal anaesthesia in all groups was suitable for single limb orthopaedic surgery. The smallest dose (4.5 mg) of hypobaric 0.15% bupivacaine resulted in more unilateral blocks, with narrower distribution and shorter duration.