Anaesthesia
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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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Breathing system filters are intended to prevent cross-infection during anaesthesia. However, there is a lack of information on whether filters prevent contamination of the breathing system by the patient. We measured the contamination of 235 used filters of four different types obtained from operating theatres: two pleated hydrophobic (BB25M and BB22/15M, Pall Medical, Portsmouth, UK) used for adult patients and two electrostatic (355/5430 Hygroboy and 355/5427 Hygrobaby, Tyco Healthcare, Gosport, UK) used for paediatric patients. ⋯ Contamination was present on the machine side of 20 (9%) filters. Current standards for testing of filters has no set "pass" level and is performed in the laboratory setting. Bioluminescence may be used in the clinical setting to elucidate factors that might increase the chance of cross-contamination between patients.
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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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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.