Anaesthesia
-
Randomized Controlled Trial Comparative Study
Bilateral intra-oral, infra-orbital nerve block for postoperative analgesia following cleft lip repair in paediatric patients: comparison of bupivacaine vs bupivacaine-pethidine combination.
This prospective, randomised, double blind study compared the efficacy of pethidine as an adjuvant to bupivacaine with the efficacy of bupivacaine alone for infra-orbital nerve block in alleviating postoperative pain in children undergoing cleft lip repair. Forty paediatric patients aged between 5 and 60 months undergoing cleft lip repair were randomly allocated to two groups of 20. ⋯ The median (IQR) duration of analgesia from the time of administration of block in group B was 18 h (14.2-20) compared to 29.1 h (24-36) in group P (p = 0.001). Addition of pethidine as an adjunct to local anaesthetic significantly prolonged the duration of postoperative analgesia without any adverse effects.
-
Randomized Controlled Trial Comparative Study
A randomised controlled trial of the electric heating pad vs forced-air warming for preventing hypothermia during laparotomy.
A randomised controlled trial was conducted to compare the efficacy of upper body forced-air warming (Bair Hugger, Augustine Medical model 500/OR, Prairie, MN) with that of an electric heating pad (Operatherm 202, KanMed, Bromma, Sweden) for maintenance of intra-operative body temperature in 60 patients undergoing laparotomy under general anaesthesia. The nasopharyngeal temperature was recorded throughout the operative period. The mean (SD) final temperatures were 36.2 (0.4) degrees C with forced-air warming and 35.5 (1.0) degrees C with electric heating pad (p < 0.01). Upper body forced-air warming is more effective than the heating pad for maintenance of body temperature during laparotomy.
-
This study was undertaken to investigate and calibrate the isoflurane output of an Oxford Miniature Vaporiser (OMV) draw-over vaporiser with reversed gas flows. Plenum or Boyles type machines have gas flowing left to right through the apparatus. Draw over anaesthesia systems, in contrast, traditionally have the carrier gas, air plus oxygen, flowing right to left through the vaporiser. ⋯ The predictable output of the OMV vaporiser assumes the correct direction of gas flows for the device. There are many second hand right to left OMV vaporisers for sale to developing countries where the nuances of vaporiser orientation add unnecessarily to the desired simplicity of anaesthesia. A simple calibration scale for reversed gas flows through the OMV vaporiser would be useful.
-
Randomized Controlled Trial
Fibreoptic intubation using three airway conduits in a manikin: the effect of operator experience.
In a randomised cross-over study, 72 anaesthetists (24 Senior House Officers, 24 Specialist Registrars and 24 Consultants) attempted to place a fibreoptic scope in the trachea of a manikin using three airway conduits: the Berman airway, the LMA Classic(trade mark) and the intubating laryngeal mask airway. The time for insertion of the airway conduit, delivery of two breaths and fibreoptic scope placement in the trachea was the primary endpoint. ⋯ The LMA Classic was considered to be the easiest conduit to use for fibreoptic scope placement by all grades of anaesthetists. We conclude that the LMA Classic is the most effective conduit for fibreoptic scope placement especially for anaesthetists with limited experience in its use.