Anaesthesia
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Randomized Controlled Trial
The effect of intravenous lidocaine on QT changes during tracheal intubation.
Laryngoscopy and tracheal intubation may provoke changes of cardiac repolarisation. The aim of this study was to assess the effect of intravenous lidocaine on the ECG changes induced by laryngoscopy and tracheal intubation. Forty-three female patients were randomly allocated to receive lidocaine (1.5 mg.kg(-1)) or placebo immediately after induction of anaesthesia and changes in the ECG and arterial blood pressure were recorded. ⋯ In the placebo group, significant increases in QTcb, QTcf and QTcF values were observed after intubation compared to either control measurements or to comparative measurements in the lidocaine group. There were no significant differences in TDR either between or within the groups. Lidocaine diminishes prolongation of QTc, induced by tracheal intubation but there is no effect of intubation on TDR.
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We report the case of a 38 year-old woman who presented initially as the driver in a road traffic accident with a Glasgow Coma Score of 14, agitated, tachycardic, tachypnoeic and hypertensive. The combination of an abdominal CT scan and clinical findings led to the decision to perform an emergency laparotomy. Her persisting symptoms and laboratory results revealed her to be manifesting acute thyroid storm; TSH of < 0.10 IU.l(-1), free T4 of 59.8 pmol.l(-1) and free T3 of 20.20 pmol.l(-1).
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Randomized Controlled Trial Comparative Study
Femoral nerve block using ropivacaine 0.025%, 0.05% and 0.1%: effects on the rehabilitation programme following total knee arthroplasty: a pilot study.
Femoral nerve blockade is recommended for analgesia following total knee arthroplasty. Following implementation of this type of postoperative analgesia in our hospital we found that active mobilization the day after surgery, may be difficult due to insufficient quadriceps muscle strength. We therefore designed a pilot study comparing the effect of ropivacaine 0.1%, 0.05% or 0.025% on the patient's postoperative rehabilitation and analgesia. ⋯ There were no significant differences in the patient's ability to actively mobilize and the pain VAS-scores. The overall satisfaction of the patients with the pain treatment was significantly better (p = 0.049) in the 0.1% compared with the 0.025% group. This pilot-study demonstrated no advantage associated with the use of a ropivacaine concentration less than 0.1%.
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Comparative Study
A needle guidance device compared to free hand technique in an ultrasound-guided interventional task using a phantom.
In this in vitro study, a needle guidance device and a 'free hand' technique for ultrasound guided needle insertion were compared in a simulated ultrasound-guided interventional task using a porcine phantom. Residents inexperienced in using ultrasonography were asked to insert a needle, using an in-plane techniques, and to make contact with metal rods at a depth of 2 and 4 cm in the phantom. ⋯ The residents ranked their satisfaction with the needle-guidance device significantly better than the 'free-hand' technique. This device may be beneficial when performing ultrasound guided peripheral nerve blocks, especially by inexperienced operators.