Anaesthesia
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Nitrous oxide pollution is common in paediatric anaesthetic practice. A questionnaire was sent to all UK members of the Association of Paediatric Anaesthetists requesting details of three areas of their paediatric practice relating to nitrous oxide: attitudes to its use; current usage; and availability of alternatives. Replies were received from 296 (68%) consultants. ⋯ One hundred and fifty-eight (54%) considered theatre pollution a problem in paediatric anaesthesia. One hundred and sixty-nine (57%) reported that in normal circumstances potential deleterious effects on patients influenced their use of nitrous oxide, whilst only 70 (24%) felt potential effects on staff influenced usage. Fifty-five (18%) felt there should be some restriction in the availability of nitrous oxide.
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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.