Anaesthesia
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Randomized Controlled Trial Clinical Trial
Effect of breathing low concentrations of volatile anaesthetic agents on incidence of adverse airway events.
The effect of breathing 0.1 minimum alveolar concentrations (MAC) of desflurane or isoflurane for three minutes on the incidence of adverse airway events on a subsequent breath of 2 MAC was investigated. Twenty-five volunteers known to develop an adverse airway event to desflurane or isoflurane took part in the study. Each volunteer was exposed to isoflurane and desflurane at least 24 h apart. ⋯ Adverse airway events decreased from 88% to 40% when tests were conducted with desflurane (p = 0.002). With isoflurane, the reduction from 60% to 52% was not statistically significant (p = 0.774). Breathing low concentrations of desflurane decreases the incidence of adverse airway events on subsequent inhalation of higher concentration of desflurane.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of xenon-based anaesthesia compared with total intravenous anaesthesia in high risk surgical patients.
Xenon, a noble gas with anaesthetic and analgesic properties, has gained renewed interest due to its favourable physical properties which allow a rapid emergence from anaesthesia. However, high costs limit its use to a subset of patients who may benefit from xenon, thereby offsetting its costs. To date, there are only limited data available on the performance of xenon in high risk patients. ⋯ TIVA 25 +/- 15 h) or in hospital (xenon: 14 +/- 12 vs. TIVA 10 +/- 6 days) did not differ significantly between the groups. Although xenon has previously been shown to exert superior haemodynamic stability, we were unable to demonstrate an advantage of xenon-based anaesthesia compared to TIVA in high risk surgical patients.
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Randomized Controlled Trial Clinical Trial
Effects of music on target-controlled infusion of propofol requirements during combined spinal-epidural anaesthesia.
The sedative effects of music were evaluated using the bispectral index (BIS) during target-controlled infusion (TCI) propofol. A total of 110 women undergoing hysterectomy were randomly allocated to receive either music or no music. Propofol was administered using target-controlled infusion and the concentration adjusted gradually to achieve an observer's assessment of alertness/sedation (OAA/S) score of 3 intra-operatively. ⋯ The music group had a significant reduction in mean (SD) induction time of sedation: 12 (12) min vs. 18 (12) min, p < 0.01; propofol target concentration: 1.6 (0.3) microg.ml(-1) vs. 2.4 (0.4) microg.ml(-1), p < 0.0001; intra-operative amount of propofol: 171 (98) mg vs. 251 (92) mg, p < 0.0001; and significantly higher levels of satisfaction with their peri-operative care: 9.6 (0.6) compared to the control group: 8.1 (1.0), p < 0.0001. No other differences were found. The results show the influence of music on the induction time of sedation, concentration and level of propofol during surgery, and suggest sedative benefits of music.