Anaesthesia and intensive care
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Anaesth Intensive Care · Dec 2005
Randomized Controlled Trial Comparative StudyA randomized trial of ultrasound-guided brachial plexus anaesthesia in upper limb surgery.
Ultrasound guidance allows real-time identification of relevant anatomy and needle position when performing brachial plexus regional anaesthesia. The aim of this investigation was to determine whether the use of surface ultrasound could improve the quality of brachial plexus anaesthesia for upper limb surgery. ⋯ Ultrasound guidance also significantly reduced (P=0.012) the incidence of paraesthesia during the performance of the blocks. Ultrasound guidance increases the quality of sensory and motor blockade in brachial plexus regional anaesthesia, and by reducing the incidence of paraesthesia during performance of the blocks, may confer greater safety.
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Anaesth Intensive Care · Dec 2005
Randomized Controlled Trial Comparative StudyComparison of forced-air warming and radiant heating during transurethral prostatic resection under spinal anaesthesia.
Forced-air warming is commonly used to warm patients intraoperatively, but may not achieve normothermia during a short procedure. Comparative trials of a new radiant warming device in general anaesthesia (Suntouch, Fisher and Paykel, Auckland, New Zealand) have had conflicting results. We conducted a randomized controlled trial to compare the efficacy and thermal comfort of the Suntouch radiant warmer and forced-air warming in patients at high risk of hypothermia during neuraxial blockade. ⋯ A large proportion of patients in both groups (46% and 33% respectively, P=0.3) were hypothermic (<36 degrees C) on arrival in the post-anaesthesia care unit. No other patient variables were significantly different. Neither warming device reliably prevented hypothermia, although forced-air warming was slightly superior.
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Anaesth Intensive Care · Oct 2005
Randomized Controlled Trial Comparative StudySub-Tenon's block in cataract surgery--a comparison of 1% ropivacaine and a mixture of 2% lignocaine and 0.5% bupivacaine.
Sub-Tenon's block for cataract surgery is an increasingly common technique. While this technique has been successfully applied, the optimal local anaesthetic solution is not known. This study was performed to assess any differences in anaesthesia and oculomotor block between 1% ropivacaine and a 2% lignocaine with 0.5% bupivacaine mixture. The results indicate that there was no difference noted in the clinical effect between the solutions.
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Anaesth Intensive Care · Aug 2005
Randomized Controlled Trial Comparative StudyIntubation conditions following rocuronium: influence of induction agent and priming.
A small priming dose of rocuronium can shorten the onset time of neuromuscular blockade. Induction agents with less cardiovascular depression also reduce the onset time. We hypothesized that ketamine, compared to thiopentone, would reduce onset time and improve intubating conditions following priming. ⋯ The proportion of good to excellent intubating conditions was higher when ketamine was preceded by priming compared to ketamine without priming (87% vs 20%; P<0.05). In both priming and control groups intubating conditions were improved when using ketamine compared to thiopentone (P<0.05). The mechanism of this effect was not clear from this study.
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Anaesth Intensive Care · Aug 2005
Randomized Controlled Trial Multicenter StudyRecovery from bispectral index-guided anaesthesia in a large randomized controlled trial of patients at high risk of awareness.
Electroencephalographic monitors of anaesthetic depth are reported to assist anaesthetists in reducing recovery times. We explored the effect of bispectral index (BIS) monitoring on recovery times in a double-blind, randomized controlled trial of 2,463 patients at high risk of awareness. Patients were randomized to BIS-guided anaesthesia or routine care. ⋯ In multivariate models, BIS monitoring, female gender, lower American Society of Anesthesiologists' physical status and shorter duration of anaesthesia predicted faster time to eye-opening after anaesthesia, and faster time to post-anaesthesia care unit discharge. BIS monitoring did not affect times to tracheal extubation among patients admitted to the intensive care unit. We conclude that BIS monitoring has statistically significant, but clinically modest, effects on recovery times in high risk surgical patients.