Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Various medications have been reported to decrease gastric content volume and thus risk for pulmonary aspiration. The majority of studies have used blind gastric tube aspiration of stomach contents as the method of measuring the volume of gastric contents. This study evaluated the accuracy of this method by first measuring gastric content volume using blind gastric aspiration and then aspirating residual content in the stomach, using a visually guided flexible fiberoptic gastroscope. ⋯ The blind aspirate volume underestimated true total gastric volume by an average of 14.7 ml and was significantly different from true total gastric volume (p less than 0.05). Blind gastric aspiration was thus demonstrated only to approximate true gastric volume. Its use to measure precisely gastric volume cannot, therefore, be recommended.
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Randomized Controlled Trial Clinical Trial
The effect of preoperative apple juice on gastric contents, thirst, and hunger in children.
The effect of 3 ml.kg-1 of apple juice given 2.6 +/- 0.4 hours preoperatively was investigated in 80 healthy children of ages five to ten years in this prospective, randomized, single blind study. The children who drank apple juice preoperatively had decreased gastric volume, thirst, and hunger (p less than 0.05). ⋯ The gastric pH was not significantly different, with the control group's gastric pH being 1.7 +/- 0.6 and the treated group's pH was 2.2 +/- 1.2. Further studies of the effects of different volumes and timing of preoperative clear fluids are indicated in paediatric patients.
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Clinical Trial Controlled Clinical Trial
"Priming" with neostigmine: failure to accelerate reversal of single twitch and train-of-four responses.
Train-of-four stimulation can shorten the apparent onset time of neuromuscular blocking drugs. This study was designed to verify whether the same occurred with neostigmine-assisted recovery, and whether this apparent acceleration could explain the previously reported effectiveness of the priming technique for reversal agents. Fourteen adults received atracurium, 0.5 mg.kg-1, during a thiopentone-nitrous oxide-enflurane anaesthetic. ⋯ No statistically significant differences were observed between single twitch in one arm and first twitch height of the train-of-four in the other arm for the next 10 min. With priming, first twitch height was 45 +/- (SEM) 5 per cent at 5 min and 85 +/- 6 per cent at 10 min, compared with 72 +/- 5 per cent (p less than 0.05) and 91 +/- 2 per cent (NS) respectively without priming. Train-of-four ratio was 28 +/- 3 per cent at 5 min and 65 +/- 5 per cent at 10 min with priming, versus 53 +/- 4 per cent (P less than 0.05) and 73 +/- 3 per cent (NS) respectively without priming.(ABSTRACT TRUNCATED AT 250 WORDS)
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Comparative Study Clinical Trial Controlled Clinical Trial
Recovery room oxygenation: a comparison of nasal catheters and 40 per cent oxygen masks.
One hundred and sixty-one ASA physical status I-III patients undergoing elective surgery were evaluated using nasal catheters versus 40 per cent O2 venturi masks. Twenty-one per cent of the patients arrived in the recovery room with hypoxia as measured with a pulse oximeter (SaO2 less than 90 per cent). Fifteen minutes later all patients who arrived hypoxic were well oxygenated on their chosen oxygen therapy. ⋯ Patients having an endotracheal tube with intermittent positive pressure ventilation or having a premedication were more apt to be hypoxic on arrival. These last two factors were closely associated and may reflect bias. The patient's gender, history of smoking, presence of obstructive lung disease, not including asthma, location of incision, or type of anaesthetic were not statistically significant risk factors.
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Plasma lidocaine concentrations, latency of onset, and duration of anaesthesia, were determined after interscalene brachial plexus block in 16 patients presenting for elective upper limb surgery. Eight patients had normal renal function and eight had chronic renal failure, as determined by creatinine clearance. ⋯ The latency of onset and duration of anaesthesia were similar in both groups. One per cent lidocaine solution may be administered to patients with normal and impaired renal function to provide effective brachial plexus blockade for short surgical procedures.