Anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of the intubating laryngeal mask airway and the Bonfils intubation fibrescope in patients with predicted difficult airways.
Tracheal intubation with the intubating laryngeal mask airway or the Bonfils intubation fibrescope was performed in 80 patients with predicted difficult airways. Mallampati score, thyromental distance, mouth opening and mobility of the atlanto-occipital joint were used to predict difficult airways. ⋯ Tracheal intubation was significantly slower with the intubating laryngeal mask airway than with the Bonfils intubation fibrescope (76 [45-155] s vs. 40 [23-77] s, p < 0.0001. Patients in the Bonfils group suffered less sore throat and hoarseness than those in the other group.
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Randomized Controlled Trial Clinical Trial
Prevention of postoperative sore throat using capsicum plaster applied at the Korean hand acupuncture point.
In a randomised, double-blind, sham-controlled study, we compared the efficacy of capsicum plaster (PAS) applied at the Korean hand acupuncture point for the prevention of postoperative sore throat in 150 patients scheduled to undergo abdominal hysterectomy. The K group had PAS applied at the K-A20 of both hands and placebo tape at both non-acupoints. The PAS was applied prior to induction of anaesthesia and removed 8 h postoperatively. ⋯ The prevalence of moderate to severe sore throat at 24 h was lower for Group K (0%) than for sham and placebo controls (16%[p = 0.038] and 19%[p = 0.032], respectively). There were no differences in the recovery room of the sore throat scores for all groups. We found that the PAS applied at the K-A20 was an alternative method for reducing postoperative sore throat.
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Comment Letter Historical Article
A response to 'Another look at Dumfries', Martin L V H, Anaesthesia 2004; 59: 180-7.
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Randomized Controlled Trial Clinical Trial
Ultrasound guidance for infraclavicular brachial plexus anaesthesia in children.
Ultrasonography may offer significant advantages in regional anaesthesia of the upper and lower limbs. It is not known if the same advantages demonstrated in adults also apply to children. We therefore performed a prospective, randomised study comparing ultrasound visualisation to conventional nerve stimulation for infraclavicular brachial plexus anasesthesia in children. ⋯ Direct ultrasound visualisation was successful in all cases and was associated with significant improvements when compared with the use of nerve stimulation: lower visual analogue scores during puncture (p = 0.03), shorter mean (median) sensory onset times (9 (5-15) min vs. 15 (5-25) min, p < 0.001), longer sensory block durations (384 (280-480) min vs. 310 (210-420) min, p < 0.001), and better sensory and motor block scores 10 min after block insertion. Ultrasound visualisation offers faster sensory and motor responses and a longer duration of sensory blockade than nerve stimulation in children undergoing infraclavicular brachial plexus blocks. In addition, the pain associated with nerve stimulation due to muscle contractions at the time of insertion is eliminated.
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Continuous flow positive pressure devices bridge the gap between mechanical and unsupported ventilation in patients recovering from critical illness. At this point, patients are often fully awake, yet the inflated tracheostomy cuff prevents them from speaking or swallowing. The aim of this study was to investigate the effects of cuff deflation. ⋯ All patients were able to vocalise following cuff deflation. Twelve patients passed a blue dye swallow screen within a day of tolerating cuff deflation. These results suggest that pressures fall slightly following cuff deflation but this is associated with respiratory stability and may allow patients to talk and swallow.