Anaesthesia
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Randomized Controlled Trial
Retention of drug administration skills after intensive teaching.
We have identified deficiencies in medical students' drug administration skills, and we attempted to address them with interactive online teaching modules and simulated critical incident scenarios. Short-term improvements have been evident with this intensive effort, but medium-term retention of skills has not been measured. A drug administration lecture, an online module and a simulated emergency scenario were offered to final year clinical students. ⋯ Participation in the simulated scenario only significantly improved examination scores when supplemented by online teaching (p = 0.002). Intensive drug administration teaching using an online module and high fidelity simulation improves drug administration skills in the medium term. Students found simulation much more engaging than online teaching.
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Randomized Controlled Trial
The effect of bolus administration of remifentanil on QTc interval during induction of sevoflurane anaesthesia.
Stimulation of the sympathetic nervous system associated with tracheal intubation causes corrected QT (QTc) interval prolongation. We postulated that the use of remifentanil during induction of anaesthesia might prevent this. ⋯ The QTc interval was significantly prolonged immediately following intubation in group S and group R0.5, but it remained stable in group R1.0, compared with the QTc interval just before laryngoscopy. It is concluded that the administration of remifentanil 1.0 microg x kg(-1) before intubation can prevent the prolongation of the QTc interval associated with tracheal intubation during induction of anaesthesia with sevoflurane.
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Randomized Controlled Trial Comparative Study
Laryngoscopy force in the sniffing position compared to the extension-extension position.
Laryngoscopy is sometimes easier with the patient's head and neck in the extension-extension position (head extension with the neck extended by the head section of the table bent down at 30 degrees) rather than the classical 'sniffing the morning air' position. We therefore tested the hypothesis that the axial force required for laryngoscopy is less in the extension-extension than the sniffing position. ⋯ The mean (SD) axial force required in the extension-extension position was lower than in the sniffing position (19.6 (7.8) N versus 23.6 (8.6) N, p = 0.04). In the setting of routine tracheal intubation, less force is required when the patient is in the extension-extension position than in the sniffing position.