Anaesthesia
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Each year millions of children undergo surgery in the developing world with inadequate facilities, equipment and drugs. In many hospitals, anaesthesia is largely dependent on the availability of ketamine. Application of well-established clinical techniques, particularly for postoperative pain control, would relieve unnecessary suffering in children. Improvements in peri-operative care are required by investment in health systems and training.
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The Department for International Development (DFID) is the UK government department with responsibility for managing Britain's aid to poor countries, with an overall budget of pound 5.3 billion in 2007-8. Our health strategy is to strengthen healthcare systems by working in partnership with governments and other stakeholders in public health in assisted countries. DFID also supports a substantial research programme, principally in health and education.
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The World Health Organization has been involved in a wide range of global healthcare initiatives for many years. Recently an initiative 'Safe Surgery Saves Lives' has been launched to improve the safety of surgery throughout the world. Safe anaesthesia is a key component to achieving this aim.
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Our understanding of how adults learn has undergone many advances in the last few years. This information needs to be used to build more effective training in anaesthesia throughout the world, especially in those countries where the need to train large numbers is critical to the development of effective medical services. Training a new generation of teachers is a key part of this.
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Randomized Controlled Trial Comparative Study
A randomised comparison of the single use LMA Flexible with the reusable LMA Flexible in paediatric dental day-case patients.
In this study we compared the performance of the single use flexible laryngeal mask airway (LMA Flexible) with the original reusable LMA Flexible in paediatric dento-alveolar day-case surgery. The aim of the study was to determine whether these two supraglottic airway devices were clinically equivalent when used for simple dental extractions in children under general anaesthesia. This randomised comparative trial in 100 healthy children used first attempt airway insertion success as its primary outcome measure. ⋯ Both devices performed equally well during surgery, with no significant differences in episodes of intra-operative airway compromise (p = 0.387), and both the single use and reusable LMA Flexible displayed excellent recovery characteristics, with no occurrences of emergence airway obstruction. No blood was discovered within the inner LMA tube shaft in either device, implying that both protected against tracheobronchial soiling. We conclude therefore that the single use LMA Flexible is an acceptable alternative to the reusable LMA Flexible.