Anaesthesia
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Case Reports
Extracorporeal carbon dioxide removal using the Novalung in a patient with intracranial bleeding.
A neurosurgical patient who required repeated surgery for intracranial haematoma developed acute respiratory distress syndrome. Raised intracranial pressure proved difficult to manage whilst attempting to maintain optimal gas exchange. ⋯ Subsequently the requirements for both respiratory and cardiovascular support were reduced. The patient made a complete neurological recovery.
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Randomized Controlled Trial Multicenter Study Comparative Study
Incidence and duration of residual paralysis at the end of surgery after multiple administrations of cisatracurium and rocuronium.
After repeated rocuronium administration there is wide inter-patient variability in the time to recover muscle function.
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Randomized Controlled Trial Comparative Study
Midazolam vs ondansetron for preventing postoperative nausea and vomiting: a randomised controlled trial.
We compared the prophylactic anti-emetic efficacy of midazolam and ondansetron in 90 patients scheduled for minor gynaecological (hysteroscopy) or urological (ureteroscopy) procedures planned to last 1-2 h under sevoflurane anaesthesia with spontaneous ventilation of the lungs via a laryngeal mask airway. Midazolam 2 mg or ondansetron 4 mg were administered intravenously 30 min before the end of surgery. ⋯ There were no significant differences in average sedation scores or pain scores. Treatment using ondansetron for anti-emetic prophylaxis did not provide a superior benefit compared to midazolam in the present study.
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We describe the use of a questionnaire to define the difficulties in providing anaesthesia in Uganda. The results show that 23% of anaesthetists have the facilities to deliver safe anaesthesia to an adult, 13% to deliver safe anaesthesia to a child and 6% to deliver safe anaesthesia for a Caesarean section. ⋯ Solutions require improvements in local management, finance and logistics, and action to ensure that the importance of anaesthesia within acute sector healthcare is fully recognised. Major investment in terms of personnel and equipment is required to modernise and improve the safety of anaesthesia for patients in Uganda.