Anaesthesia
-
Randomized Controlled Trial
Epidural analgesia and breastfeeding: a randomised controlled trial of epidural techniques with and without fentanyl and a non-epidural comparison group.
Epidural fentanyl does not have an effect on breastfeeding initiation.
pearl -
Randomized Controlled Trial Comparative Study
Effect of intra-operative pressure support vs pressure controlled ventilation on oxygenation and lung function in moderately obese adults.
Obesity impairs peri-operative lung function. To evaluate the impact of pressure support ventilation vs pressure controlled ventilation in moderately obese adults upon early postoperative lung function, we randomly assigned 68 moderately obese patients (body mass index 25-35 kg x m(-2)) undergoing minor surgery to receive intra-operative ventilation either with pressure support or pressure controlled ventilation. ⋯ Postoperatively, the pressure support ventilation group also had better lung function and oxygenation values than did the pressure controlled ventilation group (p < 0.005). We conclude that pressure support ventilation better maintains lung function than pressure controlled ventilation in moderately overweight patients scheduled for minor surgery.
-
Case Reports
Lipid resuscitation in a carnitine deficient child following intravascular migration of an epidural catheter.
A child with cerebral palsy and carnitine deficiency developed ventricular arrhythmias with loss of cardiac output during elective surgery under general anaesthesia with concomitant epidural analgesia. Sinus rhythm was restored on administration of adrenaline, but hypotension persisted despite resuscitation. ⋯ Blood samples taken before and after the lipid bolus did not demonstrate toxic concentrations of bupivacaine. This case suggests that carnitine deficiency may increase susceptibility to bupivacaine cardiotoxicity.