Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Comparative Study
Intrathecal hyperbaric 2% prilocaine versus 0.4% plain ropivacaine for same-day arthroscopic knee surgery: a prospective randomized double-blind controlled study.
Short-duration spinal anesthesia is a good option for ambulatory knee surgery. Hyperbaric 2% prilocaine has short onset and rapid recovery times and, therefore, may be well suited in this setting. The aim of this study was to compare the times to reach motor block, motor block resolution, and discharge from the postanesthesia care unit (PACU) between hyperbaric 2% prilocaine and 0.4% plain ropivacaine. ⋯ The recovery of motor block was faster after intrathecal administration of hyperbaric 2% prilocaine compared with 0.4% plain ropivacaine; however, discharge time was similar between the two groups. Both drugs showed a similar risk profile.
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Randomized Controlled Trial Comparative Study
Comparison of the endotracheal tube cuff pressure between a tapered- versus a cylindrical-shaped cuff after changing from the supine to the lateral flank position.
Positional change can displace an endotracheal tube (ETT) and change the ETT cuff pressure in a tracheally intubated patient. Endotracheal tubes with different cuff shapes may lead to different cuff pressures after positional change. We hypothesized that the intracuff pressure in the TaperGuard™ ETT with a tapered-shaped cuff would be higher than that in the conventional ETT with a cylindrical-shaped cuff after a change from the supine to the lateral flank position. ⋯ After the change from the supine to the lateral flank position, the ETT cuff pressure was significantly higher in the TaperGuard ETT than in the conventional ETT, although the extent of cephalad displacement of the ETT was comparable between the two groups. This trial was registered at Clinicaltrials.gov: NCT02165319.
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Randomized Controlled Trial Comparative Study
Role of contextualizing a crisis scenario on the performance of a cricothyrotomy procedural task.
Simulation is an important alternative to evaluate cricothyrotomy, a rare life-saving procedure. This crossover study aimed to determine whether contextualization of a crisis scenario would impact the performance of a cricothyrotomy procedural task. ⋯ Contextualization of a crisis scenario did not affect the performance of a cricothyrotomy procedural task on a tissue-mannequin simulator. These findings may have implications when considering the feasibility and cost-effectiveness for assessing the performance of cricothyrotomy procedural tasks.
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Comparative Study Observational Study
Comparison of train-of-four count by anesthesia providers versus TOF-Watch(®) SX: a prospective cohort study.
Qualitative monitoring of neuromuscular blockade using the train-of-four (TOF) count is widely used to determine the timing and dose of reversal agents for neuromuscular blockade. We compared TOF count measured manually by anesthesia providers with that determined by TOF-Watch® SX. ⋯ Anesthesia providers report higher values of TOF count compared with the TOF-Watch SX, especially at intermediate levels of neuromuscular blockade. Since the dosing guidelines for the timing and dose of reversal agents are based on the TOF count derived from the TOF-Watch SX, a manually assessed TOF count may lead to inadequate dosing and/or premature administration of reversal agents.
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Comparative Study Observational Study
A prospective observational study comparing a physiological scoring system with time-based discharge criteria in pediatric ambulatory surgical patients.
Discharge criteria based on physiological scoring systems can be used in the postanesthesia care unit (PACU) to fast-track patients after ambulatory surgery; however, studies comparing physiological scoring systems with traditional time-based discharge criteria are lacking. The purpose of this study was to compare PACU discharge readiness times using physiological vs time-based discharge criteria in pediatric ambulatory surgical patients. ⋯ This prospective study suggests that discharge decisions based on physiological criteria have the potential for significantly speeding the transit of children through the PACU, thereby enhancing PACU efficiency and resource utilization.